By Jonathan Papp on 1/22/19 10:00 AM
We recently visited a JenCare Senior Medical Center in Louisville, Kentucky. A division of ChenMed, which operates more than 50 primary care medical practices in seven states, JenCare Louisville is a Circulation client transforming care for low income seniors living with multiple chronic health conditions. Very soon, we’ll provide more detail on how the courtesy transportation at JenCare and other ChenMed practices serving diverse helps produce better patient health outcomes.
Assuming full financial responsibility for patients
Rather than providing medical care on a fee-for-service basis, JenCare instead delivers high-touch care to patients that is both affordable and substantively better in reducing hospital admissions and cost of care. JenCare is paid a flat per member per month by Medicare Advantage health plans. So, as an at-risk medical practice, JenCare proactively coordinates care to help patients enjoy the maximum number of healthy days. Tom Duncan, JenCare Kentucky Market President, tells me a single hospital admission for a patient can cost upwards of $20,000, so it’s important for JenCare to find innovative ways to keep those patients healthy.
“Our doctors have economic incentives to keep our patients healthy and out of the hospital,” Tom says. “And we know that the best way to keep seniors healthy is for primary care doctors to nurture outstanding relationships built upon the foundation of unrivaled access and VIP service.”
Increased touches, lower long-term care costs
At JenCare and other high-touch ChenMed medical practices, a core value is that primary care physicians (PCPs) invest significantly more face time with patients to deliver the personalized care needed to achieve better outcomes. JenCare patients have cell phone numbers for their PCPs so health questions get answered quickly. Plus, every JenCare patient is encouraged to simply walk-in for appointments, when needed
We spoke with Emma, a member of JenCare’s front-desk staff who does far more than typical front-desk work. Emma is part of a physician-led care team responsible for a population of about 300 patients. Her job is to support the doctors by ensuring her patients are getting into the clinic frequently, and are following through with their treatment plans. Emma knows all of her patients by name and she’s on the phone with them often. She also knows where she needs to focus her time because her care team meets twice daily with her physician leader to discuss a variety of topics — like patients who missed their appointments, patients who need treatment reminders, and patients who need to come in as soon as possible for appointments.
VIP treatment aptly describes how JenCare staff welcomes every patient like a member of the family; ensures waiting times are short, and that waiting rooms are stocked with healthy foods; sees to it that every patient receives ample face time with their trusted JenCare doctor. Plus, with on-site medication services, JenCare patients receive prescriptions right in the exam room where they can ask questions of their doctor. This opportunity dramatically improves medication adherence, and it is not uncommon for the staff to fill weekly pill organizers on a patient’s behalf, as well.
High-touch care works – especially for seniors living with multiple and major chronic health challenges. And, JenCare makes high-touch care possible by keeping primary care physician patient panels small. In stark contrast to the national average of one doctor having 2,300 patients, JenCare PCPs serve between 350 and 450 patients = less than one fifth as many patients per doctor. JenCare adheres to the proven ChenMed approach where patients average 208 minutes of face-to-face time yearly with their primary care physician. That’s more than 10 times the national average for family and general physicians (20.3 minutes yearly). And the results are impressive: 50% fewer hospital admissions and 28.1% lower cost of care.
Caring for patients as soon as they are released from the hospital
We spoke with Crystal, an Acute Case Nurse, who among other things, works to ensure patients are quickly re-connected with their JenCare PCPs after ER visits and hospital discharges. Every day, Crystal receives an alert showing which JenCare patients have been admitted to the hospital. She then works with the hospital, each patient and often each patient’s family to get those patients into the clinic to see their JenCare doctor promptly after hospital discharge. And in many instances, Crystal and other JenCare transitional care leaders will use Circulation transportation services to escort patients from the hospital directly to the clinic as soon as they are discharged.
Crystal stands on the front-lines of a multi-faceted year-round JenCare initiative that lowers patient readmissions to the hospital. Statistics show that patients readmitted to hospitals are at increased risk of death. So, JenCare centers work diligently to keep both hospital admissions and readmission rates low. In addition to getting patients discharged from hospital in for timely appointments, the care team tirelessly works to educate patients on taking their medications; makes frequent well check/social calls to at-risk patients; speeds prescribed medications to patient homes, if not picked up on the way home from hospital discharge; arranges emergent food services to better nourish mending seniors; delivers nebulizers, diabetic shoes and provides a wide variety of social services – all personalized for each patient. Moreover, each week, JenCare teams meet to discuss their 40 most-at-risk patients (called “Top 40 panels”) and “How we can do even more for these patients.”
As a result, JenCare KY’s readmission rates are significantly lower than the national average reported by CMS (about 20%). In fact, Jencare’s Louisville hospital readmission rates sunk as low as single digits in 2018. More to come on this!
Building a culture that leads to better patient care
When visiting JenCare, we were struck by the emphasis the company has placed on driving culture for both patients and staff. In just about every room we were in, we saw posters explaining the company’s mission, vision and values. For employees, we heard about softball leagues, chili cook-offs, in-house contests with prizes and other initiatives to keep morale high. For patients, we heard about several community events including one with an Elvis impersonator, smoking cessation seminars, even reunions for the graduates of those smoking cessation courses.
As Tom puts it, “We invest in our people because we know that love, accountability and passion enhance patient care.”