http://mv-voice.com/print/story/print/2011/03/18/senior-health-services-all-under-one-roof


Mountain View Voice

News - March 18, 2011

Senior health services all under one roof

El Camino says new Senior Health Center will improve care, lower costs

by Nick Veronin

El Camino Hospital's board of directors recently approved funding for a new health center that will focus on preventative care for local seniors on Medicare.

The Senior Health Center, scheduled to open this fall, will bring together a wide variety of specialists who will use the latest in medical technology to manage seniors' chronic conditions, according to Cal James, the El Camino official spearheading the project.

But while James said the new center will provide higher quality care at a lower cost through integration of services and elimination of redundancies, a local doctor is concerned that the new center will only serve to drive up costs and further fragment senior care.

"It's not going to be better care for Medicare patients — no way," said Dr. Josephine Magnuson, who runs a private practice in Mountain View. "This is the next thing to make money for the hospital."

At their March 9 meeting the, the El Camino board unanimously approved the $2.3 million project, giving hospital CEO Ken Graham the go-ahead to spend up to $1.4 million to revamp an existing building on Grant Road and $900,000 to purchase equipment.

James, chief of strategy and business at El Camino, said the new center's approach to senior care will be more comprehensive than anything currently available in or around Mountain View. It aims to keep local elderly men and women out of the emergency room, and will ultimately save money, both for the hospital and for insurance providers, he said.

He said that the Senior Health Center is sorely needed to care for a growing and increasingly underserved population of elderly in Mountain View and the surrounding area, who are reliant on Medicare and unable to get adequate treatment.

"There are seniors that are growing old at an alarming rate," James said. "These folks are underserved because a fair number of physicians here in Mountain View do not accept Medicare patients because they aren't adequately compensated for their care."

Medicare reimbursement rates do not cover the costs associated with caring for seniors, James said, especially those individuals who suffer from multiple chronic illnesses — such as diabetes, obesity and heart disease. Most doctors, James said, would like to treat these patients, but it is simply infeasible for them to do so.

Magnuson, who has practiced internal medicine in Mountain View since 1984, is skeptical.

While she acknowledged that low Medicare reimbursement rates are a real problem for doctors, Magnuson said that private insurance reimbursement is often just as inadequate.

Magnuson said, she does not turn away patients even if she knows that treating them will cost more than she will be reimbursed.

James contends that Magnuson is in the minority in this regard. He noted that many doctors continue to treat regular patients as they age into Medicare, but often end up turning away new Medicare patients.

"These physicians are wonderful people," James said, "but they have to stay in business, they have to keep their doors open."

If all goes as James plans, the Senior Health Center will function as a hub through which elderly Medicare patients can access doctors, nurses, psychiatrists, social workers, dieticians, pharmacists and other senior-oriented health professionals.

Having all these specialists working on the same individual under one roof will have many benefits, James said. Better communication among doctors and pharmacists means certain patients will have a more finely tuned prescription drug regimen. Patients won't have to go to an entirely separate office to talk to a mental health expert or to get dietary counseling.

Magnuson countered that gathering a multiplicity of specialists under one roof will give the hospital more opportunities to order expensive tests for these seniors.

"From the patient's point of view, if insurance pays for it, they say, 'let's go for it,'" she said. "There is nothing to keep the specialists from laughing all the way to the bank."

James, on the other hand, said that the Senior Health Center will streamline treatment, cut down on unnecessary procedures and medications, and is certain it will run at a loss — due mostly to low Medicare reimbursements.

And although El Camino will have to eat that loss, he said, he is hopeful that the money the hospital spends on seniors may ultimately be more than offset by unnecessary readmissions and visits to the ER.

He also anticipated that Medicare will ultimately benefit from the center, as fewer unnecessary tests, procedures and prescriptions will be ordered.

To ensure that seniors stay out of the hospital, James said that doctors and nurses will follow many of the center's patients home — in a manner of speaking.

He said that certain patients will be asked to take home digital devices that will help doctors monitor their health remotely. Those who agree may take home a dedicated cell phone that doctors or nurses will use to send them reminders to take medication, or they may have a scale equipped with Bluetooth capability, that will send daily weight measurements back to the center. James is even hopeful he might raise the funds to get some patients iPads that allow them to have video chat check-ups with nurses.

This will be of great benefit to certain seniors on Medicare who may have trouble taking care of themselves, James said. It isn't enough for a doctor to hand a frail elderly person a prescription or a recommendation for a specialist and then send him on his way, without any follow through.

"This is far different than a senior walking into a doctor's office, having their appointment and walking out without any kind of continuity," James said of the center.

"I'm not trying to make it sound like it's a panacea, because it's not, but I can't think of a better model for the care of my aging parents," he said. "We've got to find a way to make senior care affordable. If we're going to control health care costs, this kind of care is going to be mandatory."

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