Nearly every day we are subjected to negative reports about the state of our health care system as well as skyrocketing costs, and most of them have at least a measure of validity. Thankfully, Athens-Limestone Hospital and Valley Internal Medicine have been involved in a pilot program designed to cut costs while insuring quality of care, and just recently it garnered them some industry distinction from the Center for Medicare/Medicaid Services at an awards ceremony held last week in Baltimore, MD.
The purpose of the program is to reduce the 30-day readmission rate of Medicare patients to the ER for the same chronic condition. It is the brain-child of Athens-Limestone Hospital COO/CFO Randy Comer, has had Valley Internal Medicine’s Dr. Sasha Acelajado functioning as the pilot physician, and ALH’s Helen McWhorter as Care Coordinator (a role that involves being a combination of coach, accountability partner, and patient liaison). “Because ER visits are the most expensive, and some Medicare patients look upon the ER in the same way as a regular doctor’s office, this has been a way to reach out to patients with chronic care and transitional care needs, and it has been effective. We have been able to reduce their ER visits by 50%, from 24% to 12%, which is huge,” said Dr. Acelajado. Athens-Limestone Hospital was the first in the Huntsville Hospital system to try the program, and the plan is to implement it throughout the system.
Here’s how it works. “Dr. A.” (which is what her patients call her) comes up with an individualized plan for a patient with a chronic condition such as diabetes or heart disease. It could involve any number of things such as the timing of medication, diet, exercise, keeping a compliance log, etc., and she makes sure the patient understands what their responsibilities are. Then Helen McWhorter will give regularly scheduled calls to provide patient support as well as answer any questions. Ms. McWhorter went through a coaching certification program, and as far as Dr. A. is concerned, Helen is the heartbeat of the program, and the biggest reason it has been such a success. The patients also have access to a nurse hotline 24 hours a day. “Just today, we were able to squeeze in an appointment for a patient who is in the program, and without it she would have ended up in the ER,” said Dr. A.
One of the supporting organizations for the program is the National Rural Accountable Care Consortium, which helps member hospital systems achieve the Medicare goals of having 85% of payments being tied to quality and value. In addition to providing training, the NRACC provides data to identify cost-saving opportunities, implement the necessary IT structure, modify clinic workflow to address care gaps, promote evidence-based medicine, and measure patient satisfaction at the point of care. Essentially, if you have a person who can be the well-organized link between the patient, the physician, and the hospital, you have better outcomes, lower costs, less red tape, and everybody wins.
Valley Internal Medicine has two physicians: Dr. Shanna Ndong and Dr. A. They have been at their practice here in Athens for about a year, and have extensive experience both here in the states, and Dr. A. has previously practiced in the Philippines. Their clinic is located just north and east of the main hospital entrance, and the address is 710 W. Hobbs, which is the corner Sanders and W. Hobbs.
Recently we chatted at lunch, and with regard to how the clinic is run, Dr. Ndong said, “We do things a bit differently. If at all possible, we’ll squeeze in a patient for an urgent care situation on the same day, and usually we are able schedule a normal appointment within a week. We don’t want to turn anyone away.” They have adult patients of all ages, and while they have a number of female patients, Dr. A. said, “We also have our fair share of men.”
Both doctors like the challenge of helping patients with complicated medical situations, and routinely get referrals from other physicians. This means that they may need to take more time with each patient, but in doing so they are able to solve some long-standing problems and give better care. They also enjoy helping patients reduce the number of medications they are taking, if at all possible, and the pilot program has helped with that.
Congratulations to Athens-Limestone Hospital and Valley Internal Medicine, and may this partnership flourish for many years to come.
By: Ali Elizabeth Turner