Bala Vaidya*
Doctor of Health Science trainee, Campbell University, Raleigh, NC, USA Medical Co-Director, Department of Population and Public Health, Illawarra and Shoalhaven Local Health District, The Wollongong Hospital, Wollongong, NSW
Received: 19 November 2024; Accepted: 19 December 2024; Published: 02 January 2025
Citation: Bala Vaidya. “Integrating Health Care: A Comprehensive Review of the Convergent Model Literature and Impact on Health Policies.” J Healthc Adv Nur (2025): 122. DOI: 10.59462/3068-1758.3.1.122
Copyright: © 2025 Vaidya B. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
The convergent model of care is an innovative healthcare approach that integrates various models to provide holistic, patient-centered care. This literature review examines the development, implementation, and influence of the convergent model of care on health policy. Key concepts include all-inclusive organizational care, collaborative healthcare professional care, person-centered precision care, and self-care by patients and providers. The model addresses health disparities by improving accessibility, cultural competence, personalized care, and patient empowerment. It has significant implications for health policy, influencing policy development, healthcare funding, regulatory frameworks, and quality of care. Case studies from Kaiser Permanente’s integrated care model (Kaiser Permanente, n.d.), the Program of All-Inclusive Care for the Elderly (PACE) (National PACE Association, n.d.), and Brazil’s Family Health Strategy (World Health Organization, n.d.) illustrate the successful implementation of the convergent model, highlighting its impact on patient outcomes and healthcare efficiency. The review concludes that the convergent model of care represents a promising strategy for addressing the complexities of modern healthcare and achieving health equity. Future research should focus on evaluating the long-term impact of this model on health policy and patient outcomes.
The convergent model of care is an emerging approach in healthcare that emphasizes the integration of various care models to provide holistic, patient-centred care. This model aims to address the complexities of modern healthcare needs by combining elements of organizational care, collaborative care among healthcare professionals, person-centred precision care, and self-care by patients and providers [1]. This literature review explores the development, implementation, and influence of the convergent model of care on health policy.
Background
The convergent model of care integrates multiple care approaches to improve patient outcomes and healthcare efficiency. It addresses the fragmented nature of traditional healthcare systems by promoting collaboration and coordination among different healthcare providers and stakeholders [1].
Key concepts of convergent care
1. All-Inclusive Organizational Care: This concept involves integrating various healthcare services within an organization to provide comprehensive care to patients. It emphasizes the importance of organizational structures that support integrated care delivery [1].
2. Healthcare Professional Collaborative Care: This aspect focuses on collaboration between different healthcare professionals to ensure coordinated and continuous patient care. It highlights the need for effective communication and teamwork among healthcare providers [1].
3. Person-Cantered Precision Care: This concept involves tailoring healthcare services to meet the specific needs of individual patients. It emphasizes the use of precision medicine and personalized care plans to improve patient outcomes [1].
4. Self-Care by Patients and Providers: This aspect encourages patients and healthcare providers to engage in self-care practices to maintain their health and well-being. It highlights the importance of patient education and empowerment in managing chronic conditions [1].
The convergent model of care has significant implications for health policy. By promoting integrated and patient- centered care, this model can influence policy decisions in several ways:
• Policy development: Adopting the convergent model of care can lead to the development of policies that support integrated care delivery. This includes policies that promote collaboration among healthcare providers, the use of precision medicine, and patient empowerment [1].
• Healthcare funding: Policies that support the convergent model of care may lead to changes in healthcare This includes funding for integrated care programs, collaborative care initiatives, and patient education programs [2].
• Regulatory frameworks: Implementing the convergent model of care may require changes to existing regulatory frameworks. This includes regulations that support the integration of healthcare services, the use of health information technology, and the protection of patient data [1].
• Quality of care: Policies that support the convergent model of care can improve the quality of care. This includes policies that promote evidence-based practices, continuous quality improvement, and patient-centred care [2].
Several case studies and examples illustrate the successful implementation of the convergent model of care and its impact on health policy:
• Integrated care models in Europe: The World Health Organization (WHO) has documented various integrated care models in Europe that align with the convergent care model’s principles. These models have improved patient outcomes and healthcare efficiency [1].
• Care transformation initiatives: A systematic review of care transformation initiatives highlights the importance of collaboration, leadership, and coordination in achieving successful care transformation. These initiatives have influenced health policy by promoting integrated and patient- centred care [2].
The convergent model of care addresses health disparities by integrating various care approaches to provide holistic, patient-centered care. Here is how it specifically targets health disparities:
All-Inclusive organizational care
• Integration of services: By integrating various healthcare services within an organization, the convergent model ensures that patients receive comprehensive care. This reduces fragmentation and ensures that all aspects of a patient’s health are addressed, particularly beneficial for underserved populations with multiple health needs [1].
• Accessibility: Integrated care models improve accessibility to healthcare services, making it easier for patients from disadvantaged backgrounds to receive care without navigating multiple systems [1].
Healthcare professional collaborative care
• Team-based approach: Collaborative care involves a team of healthcare professionals working together to provide coordinated care. This approach ensures that patients receive continuous and comprehensive care, which can help reduce disparities in health outcomes [3].
• Cultural competence: Collaborative care teams often include professionals from diverse backgrounds, which can improve cultural competence and ensure that care is tailored to the specific needs of different populations [3].
Person-Cantered precision care
• Personalized care plans: The convergent model focuses on precision care, tailoring healthcare services to meet the specific needs of individual This personalized approach can help address the unique health challenges faced by marginalized populations [1].
• Use of technology: Precision care often involves the use of advanced technologies and data analytics to identify and address health disparities. For example, genetic testing and personalized treatment plans can help reduce disparities in chronic disease management [4].
Self-Care by patients and providers
• Patient empowerment: The convergent model emphasizes patient education and empowerment, encouraging patients to take an active role in their health care. This can help reduce health disparities by improving health literacy and enabling patients to manage their health more effectively [5].
• Support for self-care: Providing resources and support for self-care can help patients from disadvantaged backgrounds manage chronic conditions and maintain their health, reducing the overall burden of health disparities [5].
Influence on health policy
• Policy development: The convergent model can influence health policy by promoting the development of policies that support integrated and patient-centred care. This includes policies that address social determinants of health and aim to reduce health disparities [1].
• Funding and resources: Policies that Support the Convergent Model May Lead to Increased Funding for Integrated Care Programs and Initiatives Aimed at Reducing Health Disparities [1].
• Regulatory changes: Implementing the Convergent Model May Require Changes to Regulatory Frameworks to Support Integrated Care Delivery and Protect Patient Data [4].
Case studies and examples
• Integrated care models in Europe: Various integrated care models in Europe have successfully reduced health disparities by providing comprehensive and coordinated care to underserved populations [1].
• Care transformation initiatives: Initiatives focusing on care transformation through collaboration and coordination have significantly improved health outcomes for marginalized populations [3].
Examples of successful convergent care programs that target specific populations:
Kaiser Permanente’s Integrated Care Model
Target population: General population, including those with chronic conditions.
Description: Kaiser Permanente is a leading example of an integrated care model that combines healthcare services under one organizational umbrella. This model emphasizes coordinated care across various specialties and services, ensuring patients receive comprehensive and continuous care. Integrating electronic health records (EHRs) facilitates communication among healthcare providers, improving patient outcomes and reducing healthcare costs [6].
Impact: Studies have shown that Kaiser Permanente’s integrated care model leads to better management of chronic diseases, reduced hospital admissions, and improved patient satisfaction [6].
Program of all-inclusive care for the elderly (PACE)
Target population: Elderly individuals who are eligible for nursing home care.
Description: PACE provides comprehensive medical and social services to elderly individuals, allowing them to remain in their communities rather than moving to nursing homes. The program integrates primary care, specialty care, social services, and long-term care, all coordinated by an interdisciplinary team.
Impact: PACE has been successful in improving health outcomes, reducing hospitalizations, and enhancing the quality of life for elderly participants [6].
Camden coalition of healthcare providers
Target Population: High-need, high-cost patients in Camden, New Jersey.
Description: The Camden Coalition focuses on providing coordinated care to patients with complex medical and social needs. The program uses a “hot spotting” approach to identify and target the highest-need patients, providing intensive care coordination and support.
Impact: The program has significantly reduced hospital readmissions and emergency department visits, leading to better health outcomes and lower healthcare costs for the targeted population [7].
Community health workers (CHWs) in brazil
Target Population: Low-income and rural populations.
Description: Brazil’s Family Health Strategy employs community health workers to provide primary care services in underserved areas. CHWs visit households to deliver preventive care, health education, and basic medical services, acting as a bridge between the community and the healthcare system.
Impact: This program has improved access to healthcare, reduced infant mortality rates, and increased vaccination coverage in low-income and rural areas.
Veterans’ Health Administration (VHA) Patient-Aligned Care Teams (PACT)
Target population: U.S. military veterans.
Description: The VHA’s PACT model focuses on providing patient-centred, team-based care to veterans. Each team includes a primary care provider, nurse care manager, clinical associate, and administrative clerk who work together to coordinate care and manage chronic conditions.
Impact: The PACT model has improved care coordination, increased patient satisfaction, and reduced hospitalizations and emergency department visits among veterans.
Health leads
Target population: Low-income patients with unmet social needs.
Description: Health Leads partners with healthcare providers to address the social determinants of health by connecting patients with essential resources such as food, housing, and employment. The program integrates social needs screening and resource referral into clinical care.
Impact: Health Leads has successfully improved health outcomes by addressing the root causes of health disparities and reducing healthcare utilization among low- income patients.
These examples demonstrate how the convergent model of care can be effectively implemented to address the unique needs of specific populations, leading to improved health outcomes and reduced disparities.
Replicating successful convergent care programs in other regions involves several key steps to address the unique needs and contexts of the new regions. Here is a comprehensive guide on how to achieve this:
Understand the core components of successful programs
• Identify key elements: Determine the core components that made the original program successful. This includes organizational structures, care coordination mechanisms, patient engagement strategies, and technology use.
• case studies: review detailed case studies of successful programs to understand their implementation processes, challenges, and outcomes [6].
Assess local needs and context
• Community needs assessment: Conduct a thorough assessment of the local population’s health needs, existing healthcare infrastructure, and socio- economic conditions.
• Stakeholder engagement: Engage Local Stakeholders, Including Healthcare Providers, Patients, Community Leaders, And Policymakers, To Understand Their Perspectives and Gain Their Support [8].
Adapt the model to local context
• Customization: Adapt the core components of the convergent care model to fit the local context. This may involve modifying care pathways, integrating local health services, and addressing specific health disparities.
• Cultural sensitivity: Ensure the adapted model is culturally sensitive and aligns with local values and practices [9].
Develop a comprehensive implementation plan
• Phased approach: Implement the program in phases to allow for adjustments based on initial feedback and outcomes. Start with pilot projects before scaling up.
• Training and capacity building: Train healthcare providers and staff to ensure they are equipped to deliver integrated This includes training on new technologies, care coordination, and patient engagement strategies [8].
Secure funding and resources
• Funding sources: Identify and secure funding from various sources, including government grants, private sector investments, and international aid.
• Resource allocation: Ensure that resources are allocated efficiently to support the implementation and sustainability of the program [8].
Monitor and evaluate the program
• Continuous monitoring: Establish a robust monitoring and evaluation framework to track the program’s progress and outcomes. Use key performance indicators (KPIs) to measure success.
• Feedback mechanisms: Implement feedback mechanisms to gather input from patients, healthcare providers, and other stakeholders. Use this feedback to make continuous improvements [9].
Policy and regulatory support
• Advocacy: Advocate for policy changes that support the implementation of convergent care models. This includes policies that promote integrated care, funding for healthcare innovation, and regulatory frameworks that facilitate care coordination.
• Regulatory compliance: Ensure that the program complies with local regulations and standards. This includes data protection laws, healthcare accreditation standards, and professional licensing requirements.
Examples of successful replication
• Camden coalition of healthcare providers: The success of the Camden Coalition’s hot spotting approach has inspired similar programs in other U.S. cities. These programs adapted the core principles of intensive care coordination and data-driven targeting to address local healthcare needs [9].
• Brazil’s family health strategy: Brazil’s community health worker model has been adopted in various countries to improve access to primary care in underserved Each adaptation considered local healthcare infrastructure and cultural contexts [8].
Involving marginalized or hard-to-reach communities in program design is essential for creating compelling and inclusive initiatives. Here are some strategies to ensure meaningful engagement:
Understand the community
• Community needs assessment: Conduct thorough assessments to understand the specific needs, challenges, and strengths of the This can involve surveys, focus groups, and interviews.
• Cultural competence: Develop an understanding of the cultural, social, and economic contexts of the community. This helps in designing programs that are culturally sensitive and relevant [10].
Build trust and relationships
• Engage community leaders: Work with trusted community leaders and organizations who can act as intermediaries and advocates. Their involvement can help build trust and facilitate communication.
• Transparency: Be transparent about the goals, processes, and potential outcomes of the program. This helps in building trust and ensuring that the community feels valued and respected [11].
Use participatory approaches
• Co-Design workshops: Involve community members in the design process through workshops and collaborative sessions. This ensures that their voices are heard and their ideas are incorporated into the program.
• Participatory Action Research (PAR): Use PAR methods to engage community members as co- researchers. This approach empowers them to take an active role in identifying issues and developing solutions [10].
Ensure accessibility
• Flexible engagement methods: Use a variety of engagement methods to reach different segments of the community. This can include in-person meetings, online platforms, and mobile outreach.
• Language and literacy: Provide materials and conduct meetings in the preferred languages of the community. Use clear and simple language to ensure that information is accessible to all.
Address barriers to participation
• Logistical support: Provide support such as transportation, childcare, and stipends to remove barriers to participation.
• Safe spaces: Create safe and welcoming environments where community members feel comfortable sharing their experiences and ideas.
Continuous feedback and adaptation
• Feedback mechanisms: Establish ongoing feedback mechanisms to gather input from the community throughout the program’s lifecycle. This can include regular check-ins, surveys, and suggestion boxes.
• Adaptation: Be willing to adapt the program based on community This shows that their input is valued and can lead to more effective and responsive programs.
Empowerment and capacity building
• Training and education: Provide training and education to community members to build their capacity to participate in program design and implementation.
• Leadership opportunities: Create opportunities for community members to take on leadership roles within the program. This can help build a sense of ownership and empowerment.
Examples of successful engagement Camden coalition of healthcare providers
• Approach: Engaged high-need, high-cost patients through intensive care coordination and support. Used a “hot spotting” approach to identify and target the highest-need patients.
• Outcome: Reduced hospital readmissions and emergency department visits, leading to better health outcomes and lower healthcare costs.
Brazil’s family health strategy
• Approach: Employed community health workers to provide primary care services in underserved areas. CHWs visited households to deliver preventive care, health education, and essential medical services.
• Outcome: Improved access to healthcare, reduced infant mortality rates, and increased vaccination coverage in low-income and rural areas.
The convergent model of care addresses health disparities by integrating various care approaches to provide holistic, patient-centred care. By promoting accessibility, cultural competence, personalized care, and patient empowerment, this model can significantly reduce health disparities and improve health outcomes for underserved populations. Its influence on health policy further supports the development of policies and initiatives to achieve health equity.
The convergent model of care represents a promising approach to addressing the complexities of modern healthcare. By integrating various care models and promoting collaboration among healthcare providers, this model can improve patient outcomes and healthcare efficiency. Its influence on health policy is significant, leading to policies that support integrated care delivery, changes in healthcare funding, and improvements in the quality of care. Future research should focus on evaluating the long-term impact of the convergent model of care on health policy and patient outcomes.
Replicating successful convergent care programs in other regions requires a careful balance of fidelity to the original model and adaptation to local contexts. By understanding the core components of successful programs, assessing local needs, engaging stakeholders, and securing necessary resources, regions can effectively implement and sustain convergent care models that improve health outcomes and reduce disparities.
Community engagement and buy-in are essential for the successful replication of healthcare programs. They ensure that programs are tailored to local needs, build trust, enhance design and implementation, increase participation, and promote sustainability. By actively involving the community, healthcare programs can achieve better health outcomes and long-term success.
Involving marginalized or hard-to-reach communities in program design requires a thoughtful and inclusive approach. By understanding the community, building trust, using participatory methods, ensuring accessibility, addressing barriers, and continuously adapting based on feedback, programs can be more effective and equitable. Empowering community members through education and leadership opportunities further enhances the sustainability and impact of these initiatives.