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Friday, Apr 19, 2024

Pilot Program Studies Hospital-Doctor Handoff

In 2014, Valley Presbyterian Hospital received more than $1 million in grant money to change the way hospitals communicate with primary care providers. To pursue that goal, the Van Nuys facility collaborated with medical clinics Valley Community Healthcare in North Hollywood and Northeast Valley Health Corp. in San Fernando to implement a pilot program, which just reached its halfway point over the summer. The aim of the three-year project, funded by L.A.-based UniHealth Foundation, is to reduce hospital readmissions by integrating medical records and having case managers available at Valley Presbyterian to oversee patient follow-up. The program is anticipated to impact about 18,000 Medi-Cal enrollees. In the program, if a patient checks in for an emergency room visit at Valley Presbyterian, the new IT system will notify the hospital if that patient receives primary care at Valley Community or Northeast Valley Health. From there, a case manager is assigned to the patient to help with transportation, follow-up appointments and everything necessary to keep that patient healthy and out of the hospital. Furthermore, hospital information is transmitted back to the clinics to continue care and accountability through the patient’s primary doctor. Under the Affordable Care Act, hospitals are penalized if patients are readmitted within a certain timeframe. In addition, the law has expanded insurance coverage — which doubled Valley Community’s patient population to 30,000 among its three locations. The pilot program benefits all three organizations involved as the hospital should see a reduction in readmission fines, while the medical clinics should see an increase in patient satisfaction by improving health and reducing costs. “We are in year two and are starting to see results,” said Paula Wilson, chief executive of Valley Community. “If this pilot is successful, I would expect continuation and trying to replicate it in other areas.” MedRisk Closure Managed physical medicine and diagnostic imaging provider MedRisk Inc. is closing its Calabasas facility on Oct. 15 to consolidate operations. The good news is all 35 full-time employees working at the 5016 Parkway Calabasas location will either work from home or relocate to one of the company’s other two offices, according to MedRisk’s Vice President of Marketing Rommy Blum. “We are expanding and ramping up diagnostic and imaging services, so we want to be able to manage all our call center professionals and health care advocates in centralized locations,” she said. Headquartered in King of Prussia, Penn., MedRisk has more than 700 employees with its two remaining locations in Pennsylvania and Arizona. Its Calabasas site was the result of an earlier acquisition of diagnostic imaging company Medical Diagnostic Associates Management Inc., which was headquartered at the Valley office. Anthem Fight Diabetes Anthem Blue Cross, a subsidiary of Indianapolis-based health insurer Anthem Inc., has partnered with numerous Valley community groups — including Valley Jewish Community Center of Woodland Hills — to offer a yearlong diabetes prevention program for at-risk commercial members. The program, which is sanctioned by the Centers for Disease Control and Prevention in Atlanta, incorporates a weekly class for 16 weeks that encourages healthy eating habits and exercise. After that, participants attend a monthly session to check on progress for the remainder of the program. They are also divided into groups to encourage accountability and support. Currently, the course is covered as a preventative service for commercial members who are pre-diabetic. But Medicare is in the process of making it a benefit as well, according to Dr. Laura Clapper, medical director at Anthem Blue Cross and leader of the diabetes prevention program. “One of the things I think is really exciting about the diabetes prevention program is the connection we are making from nontraditional providers like Black Women for Wellness and Valley Jewish Community Center to more traditional providers. It’s really evidence of Anthem’s commitment to a community approach and supporting member choice,” she said. An objective of the program is to lose 5 to 7 percent of body weight, which is the sweet spot for diabetes prevention, according to Clapper. She said losing this amount and decreasing body mass index promotes better insulin utilization, reducing the chances of developing Type 2 diabetes. To shed the pounds, the program focuses on three key steps — tracking food, increasing activity to 150 minutes per week and regularly weighing oneself. By incorporating organizations like Black Women for Wellness of Los Angeles and New York-based Weight Watchers International Inc.’s Valley facilities, Anthem is offering a wide range of geographic locations with varying cultures, so participating members can find a site that works for them. Staff Reporter Stephanie Henkel can be reached at (818) 316-3130 or [email protected].

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