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health

Mesa-based NextCare Expands in Oklahoma

Access Medical Centers of Oklahoma – a brand of Mesa-based NextCare Holdings, Inc., one of the nation’s leading providers of urgent care medicine and occupational medical services – announces the opening of a new center in the Oklahoma City metro area. This new clinic brings the total number of network locations throughout Oklahoma to 16.

“We are excited to be part of Moore’s close-knit community, and offer residents the highest standard for quality and service within the urgent care industry,” said John Julian, CEO of NextCare Holdings. “Access Medical Centers offer a well-connected network of urgent care clinics in Oklahoma. We are honored to provide exceptional health care to communities throughout the state.”

This new location also builds upon the alliance between Access Medical Centers and Integris Health. The two entities have formed an affiliation to ensure patients have a complete continuum of care.
Says Bruce Lawrence, President and CEO for INTEGRIS Health, “The Access Medical Centers urgent care affiliation offers a gateway to INTEGRIS quality care within metro Oklahoma City. This new location helps us better serve the needs of people in the community.”

The Moore clinic is open seven days a week from 8 a.m. to 8 p.m., Monday through Friday, and 8 a.m. to 8 p.m. Saturday and Sunday. The clinic accepts most insurance plans, including SoonerCare, Blue Cross and Blue Shield, United Health Care, Medicare, Workers Compensation, and many others.

NextCare has an aggressive growth plan in new and existing markets, having opened 27 new clinics across the U.S. in 2013 alone. For more information, visit www.NextCare.com or call 888-381-4858.

Medical Technology - AZ Business Magazine January/February 2012

Del Webb Gives $500,000 to cut John C. Lincoln readmissions

Love, they say, makes the world go round. Apparently, at John C. Lincoln Hospitals in Phoenix, love also reduces hospital readmissions by frail Medicare patients.

A program that hires military combat medics and corpsmen to care for discharged elderly patients like beloved grandparents has slashed the John C. Lincoln Hospitals’ Medicare patient readmission rates to an astonishing 6 percent.

It’s not that the rates were bad to begin with. Before the program started last October, the Medicare readmission rates at John C. Lincoln Hospitals hovered around a respectable 18 percent – the national average is 20 percent. Those readmissions cost the federal government more than $17 billion annually.

The Centers for Medicare and Medicaid Services (CMS) launched a campaign to encourage hospitals to do whatever necessary to maintain the health of discharged Medicare hospital patients with congestive heart failure, heart attacks or pneumonia, so fewer of them would be readmitted within the first 30 days after leaving the hospital. Financial incentives for readmission rate reduction and penalties for readmission rate increases were built into the CMS campaign.

John C. Lincoln’s innovative response to the CMS challenge mobilizes a cadre of veterans as transition coaches who provide designated Medicare patients with a personal touch along with support and guidance – to help them with follow-up medical instructions, prescription drugs, doctor appointments, nutrition and costs of care.

In the long run, reduced readmissions generated by the transition coaches produce significant savings for John C. Lincoln that far exceed program costs. But initial assistance to maximize the program’s effectiveness was needed.

The Del E. Webb Foundation stepped into that gap and awarded a $500,000 two-year grant to John C. Lincoln Health Foundation to support and expand the Health Network’s transition coach services. The grant will provide $250,000 this year to hire an additional five coaches, plus an additional $250,000 in July 2014 to hire five more, bringing the total number of John C. Lincoln transition coaches to 14.

The additional coaches make it possible to provide transition services not only to designated Medicare inpatients, but to all frail elderly patients being discharged from both hospitals, regardless of Medicare status or membership in John C. Lincoln’s Accountable Care Organization.

“But our primary goal is not to chase statistics,” says Transition Coach Program medical director John Lees, DO. “It is to reduce readmissions by helping at risk patients.

“Our first goal is to take care of discharged patients the way their own children or grandchildren would take care of them . . . to love on them and make sure their food, safety, medication, follow-up doctor visits, transportation or other everyday needs get taken care of, so their health is maintained, so they don’t relapse for preventable reasons,” Dr. Lees said. “Our goal is their optimal health.”

A key component, Dr. Lees said, is hiring transition coaches from the pool of trained military medics and corpsmen returning from active service in the Mideast. In spite of their rigorous training and experience, these soldiers are considered unqualified for most civilian health care positions. John C. Lincoln is providing employment relevant to the work they did in the field while harnessing their abilities, knowledge and disciplined initiative to address the needs of discharged Medicare patients.

Using the strategic, creative and responsive skills learned during military service, the transition coaches work with patients in the following major areas:

·         Medication self management – Making sure patients have access to pharmacies, can afford to their prescriptions, know how and when to take their medications, and understand the drugs’ purpose and potential side effects.
·         Physician follow-up – Making sure the patients know when to see primary or specialty physicians for follow-up care, that such visits are scheduled and that the patient has needed transportation.
·         Patient-centered health records – Teaching the patient to use a personal health record with a computer or smart phone to facilitate communication and continuity of care.
·         Nutrition and home safety – Making sure the patient and pets have adequate healthy food so that malnutrition doesn’t impair recovery; checking the home for hazards that can lead to falls or other injuries.
·         Red flags – Making sure the patient recognizes symptoms that indicate his or her condition is worsening and knows what to do to get help.

These services, none of which involve medical care, are essential to the preservation of patients’ health, Dr. Lees said.

“Many have asked why our program is so much more successful than other hospitals’ efforts to maintain the health of their discharged Medicare patients,” Dr. Lees said. “We’re still evaluating our experience to find out why.”

However, some factors the transition team believes are crucial to their success include:

·         Veterans relate well with patients.
·         Veterans are geared to recognize and solve problems, traditionally or out-of-the-box, creatively and immediately.
·         Transition coaches with access to John C. Lincoln’s electronic health records system don’t have to rely on their patients for health history, medication review or other information, because all that can be accessed on a computer, laptop, tablet, iPhone or Android. Follow-up doctor appointments or prescription refills can be made expediently online.

“We are enthusiastic about our initial success,” Dr. Lees said, “and we hope that our program, the national winner of the 2012 White House Healthcare Policy Challenge, will be recognized as a best practice that will become a model for the nation.

“There are currently more than 20,000 military combat medics and corpsmen returning from Iraq and Afghanistan who need jobs and who could help preserve the health of Medicare patients released from hospitals across America,” Dr. Lees said. “Wouldn’t it be ideal if they could do what our transition coaches are doing?”

Banner Good Samaritan Hospital

Innovative Banner program helps cut healthcare costs

In its first year of performance, Banner Health Network (BHN) was successful in delivering more coordinated care and a considerable savings over traditional fee-for-service Medicare plans as part of the Medicare Pioneer Accountable Care Organization (ACO). BHN leaders are now focusing efforts on the true test of this model– whether it can be sustained and improved upon in coming years.

“We are very pleased by our first year results in Medicare’s Pioneer Accountable Care Organization,” said Tricia Nguyen, Chief Medical Officer for Banner Health Network. “Our ability to deliver shared savings, in excess of $13 million, has been the result of more coordinated care by our providers, advanced population health technology and surrounding our most vulnerable and chronically ill beneficiaries with supportive case management.”

In the first year BHN also demonstrated an ability to reduce hospital admissions, hospital length of stay and the need for hospital readmissions by supporting beneficiaries when they are most at risk and in need of care and advocacy. BHN was a top performer in terms of shared savings compared to other Pioneer organizations nationally.

“Through our experience, we believe the value-based Pioneer ACO model has merit, and that it has the potential to diminish the predominance of fee-for-service plans in government and private sectors,” said Chuck Lehn, CEO for Banner Health Network. “It is the best solution at this time for creating sustainability for the Medicare program, and could be the basis for historic change in the U.S. healthcare industry.”

Banner Health Network will proceed with the Pioneer ACO program in Performance Year 2 (calendar year 2013) and has begun recruiting additional physicians for Performance Year 3 (calendar year 2014).

The Centers for Medicare and Medicaid Innovation (CMMI), that operates the Pioneer program, reported that the results from the Pioneers overall were promising. “These results show that Pioneer ACOs have been successful in reducing costs for Medicare, improving the quality of care for their patients, and that incentives to align payment with quality can work.”

In December 2011, Banner Health Network announced that it had been selected as one of only 32 organizations in the country to demonstrate the Pioneer ACO Model.  The central premise of the Pioneer ACO effort is to create value through a highly coordinated, collaborative network of providers who are focused on achieving the highest level of wellness possible for their Medicare patients.

The financial incentive for Pioneer physician providers is to have improved financial benefit through shared savings, not increased volume of services that are reimbursed in a traditional fee-for-service model. Provider revenues are generated through a percentage of Medicare savings. Further, if provider expenses are greater than available Medicare funding, the individual ACO is at risk for that loss.

In addition to participating in the Medicare Pioneer ACO, BHN has developed accountable care relationships with Blue Cross Blue Shield of Arizona, Aetna, Health Net, United Healthcare and Cigna in the last 18 months.

BHN is comprised of Banner Health employed physicians and Banner affiliated physicians; 13 Banner hospitals (12 in the Phoenix metro area); Banner Health Centers and Clinics; and other Banner services in Arizona. The Network ensures convenient access to Medicare members with more than 2,600 physicians located throughout Maricopa County and into Pinal County.

Medical Technology - AZ Business Magazine January/February 2012

Arizona Ranks 23rd for Senior Health

Arizona is ranked 23rdfor senior health, according to the inaugural edition of United Health Foundation’s America’s Health Rankings Senior Report: A Call to Action for Individuals and Their Communities.

United Health Foundation commissioned the America’s Health RankingsSenior Report to examine the health challenges affecting today’s seniors and to encourage the nation and local communities to find ways to improve senior health. Americans are living longer but sicker lives and that America’s senior population is poised to grow more than 50 percent between 2015 and 2030, making senior health a timely and critical national issue.

The America’s Health Rankings Senior Report is the most comprehensive rankings to date of senior health on state levels and can be viewed and downloaded at www.americashealthrankings.org. This report builds on the annual America’s Health Rankings report which, for 23 years, has presented the definitive analysis of national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socioeconomic data to determine national health benchmarks and state rankings.

“United Health Foundation’s America’s Health Rankings Senior Report is a highly valuable tool to help gain a greater understanding of the heath challenges faced by Arizona’s seniors,” said Robert Beauchamp, MD, Medical Director for UnitedHealthcare in Arizona. “Arizona’s growing senior population points to the urgency of identifying key opportunities for improving senior health and pursuing effective solutions at the national, state, community and family levels.”

The America’s Health RankingsSenior Report assesses state-level performance on 34 different elements, including both health determinants and health outcomes.

The America’s Health Rankings Senior Report finds that Arizona has its share of strengths and challenges for senior health.

Arizona’s Strengths:

* Ranks 1st in availability of hospice care
* Ranks 2nd in the rate of hospital deaths
* Low prevalence of physical inactivity (5th in the U.S.)

Arizona’s Challenges

* Ranks 44th for number of seniors who are underweight
* Ranks 48th for highly rated nursing homes
* Low percentage of volunteerism (18.8 percent)
*
Among all 50 States: Minnesota leads the nation for senior health, followed by Vermont, New Hampshire, Massachusetts and Iowa. Mississippi ranks 50th, preceded by Oklahoma, Louisiana, West Virginia, and Arkansas.

Older Americans are experiencing troubling rates of chronic health conditions, according to the Senior Report. About 80 percent of seniors are living with at least one chronic health condition, while 50 percent of seniors have two or more chronic health conditions, according to the Centers for Disease Control and Prevention. In addition, the report finds that more than 25 percent of seniors nationwide are obese.

“Chronic illness is unnecessarily high among seniors,” said Rhonda Randall, D.O., senior advisor to United Health Foundation and chief medical officer, UnitedHealthcare Medicare & Retirement. “The coordination of care for seniors, particularly the 50 percent of the population with multiple chronic illnesses, is complex and increases pressure on our country’s caregivers and our health care system.”

Through its portfolio of Medicare plans, UnitedHealthcare supports Medicare beneficiaries in Arizona with clinical solutions that help address health concerns underscored in the America’s Health Rankings Senior Report. These programs include:

* Integrated disease management and care coordination programs, which provide select Medicare Advantage plan members with chronic health conditions – such as diabetes or certain types of heart disease – needed resources and support;
* UnitedHealthcare’s HouseCalls program, offering qualified Medicare Advantage plan members an at-home visit with a health care practitioner to assess health needs and discuss personal health concerns;
* UnitedHealthcare’s PharmAssist service, which provides select Medicare Advantage plan members with one-on-one counseling sessions with specialty-trained plan pharmacists to understand how to take their medications as prescribed.

America’s Health Rankings Senior Report: A Call to Action for Individuals and Their Communities offers a comprehensive analysis of senior population health on a national and state-by-state basis across 34 measures of senior health. In commissioning the report, United Health Foundation seeks to promote discussion around the health of Americans 65 years and older while driving communities, governments, stakeholders, families and individuals to take action to improve senior health.

Researchers drew data from more than 12 government agencies and leading research organizations to create a focused, uniquely rich data set for measuring senior health at the state level, including the U.S. Department of Health and Human Services, the U.S. Department of Commerce, the U.S. Department of Labor, The Dartmouth Atlas Project, the National Foundation to End Senior Hunger and the Commonwealth Fund.

In addition to producing the America’s Health Rankings Senior Report, United Health Foundation also produces the annual America’s Health Rankings report. For 23 years, America’s Health Rankings has provided an analysis of national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socioeconomic data to determine national health benchmarks and state rankings. The Rankings employs a unique methodology, developed and annually reviewed by a Scientific Advisory Committee of leading public health scholars.

For more information on both reports, visit www.americashealthrankings.org.

SCAN Health Plan

SCAN Health Plan Arizona Offers ‘Wellness Way of Living’ Programs In May

A healthy cooking demonstration and sampling offered by SCAN Health Plan. In honor of National Salad Month, the May demonstration will feature salads and will be held on May 16 from 11:30 a.m. to 1 p.m.

As part of the eight-month series called “Wellness Way of Living,” a one-hour workshop on physical activity will be held on May 23 at 10 a.m. The discussion will include the health benefits of physical activity, including disease prevention and control, improved brain function and balance. Participants will also learn:
> Recommended amounts of physical activity.
> Easy ways to add physical activity to their daily routines.
> Tips for staying motivated.
> Exercises for seniors that can be done in the living room.

These classes are open to SCAN health plan members as well as the general public; however, space is limited, so pre-registration is required. Both presentations will be held at the SCAN Connections Resource Center at 1313 E. Osborn Road in Phoenix. Anyone interested in attending may call 602-778-3420 to register.

“Discovering new, interesting and delicious ways to prepare vegetables makes it much easier to infuse more of them into your diet,” said Susan Cypert, senior community resource specialist for SCAN Health Plan Arizona. “Together the healthy cooking demonstrations and wellness presentations offered at the SCAN Connections Resource Center help seniors live healthier, stay active and remain independent.”

For 35 years SCAN Health Plan has been focusing on the unique needs of people with Medicare and today is the fourth-largest not-for-profit Medicare Advantage plan in the United States. SCAN Health Plan Arizona serves approximately 15,000 members in Maricopa and Pima counties. Further information is available at scanhealthplan.com.