Published: Monday, July 30, 2007
Better care saves cash, Everett Clinic finds
The Everett Clinic has signed up for one of the biggest challenges in health care: Find a way to provide seniors with better care and still save money.
It is one of only 10 medical clinics nationally participating in the Medicare project. The federal program expects to spend $454 billion this year on medical care for seniors.
The challenge involves monitoring the health and medical care of 9,313 Medicare patients in the clinic's Stanwood, Marysville and Everett offices.
By the end of the project's first year, The Everett Clinic was able to treat its patients for $407,850 less that the cost of treating comparable types of patients at other area medical clinics, according to a Medicare analysis.
Its success, though, wasn't just measured in dollars and cents. Along the way, it won over patients such as 89-year-old Greg Garske of Everett, whom even his daughter described with a loving chuckle as "a curmudgeon."
"My father was not a big fan of our health-care system," said Carol Volpe of Seattle. "Going to the doctor was always a frustrating experience with him."
But the coordination among local health-care organizations that the Medicare demonstration project helped foster "allowed my father to be independent far longer than he would have," almost literally until the day he died earlier this month, Volpe said.
The program is "filling a niche that's a huge need and will grow as baby boomers get older," she said.
"There was such continuity with everything, and with our health-care system, that often isn't the case," Volpe said. "One hand doesn't know what the other hand is doing."
What made the difference was the time and attention her father received, Volpe said. "I didn't see other doctors give that kind of attention to and with that kind of detail with the elderly."
The Everett Clinic launched the program in April 2005. It is now in its third year. "We made it our goal to improve the care delivered to seniors in our community," said Dr. James Lee, an internist who is overseeing the Medicare demonstration program.
Patients are monitored for how well health problems, such as diabetes and heart disease, are managed and whether patients received regular health screenings, such as those for breast and colon cancers.
"We also were interested in looking at coordinating care between the hospital, nursing home and the clinic," Lee said, since many elderly patients "fall through the cracks" as they move from one of these health care settings to another.
For example, as seniors are discharged from the hospital, they often don't have a follow-up appointment set to see their doctor. And they're often confused about the instructions they get on what steps they should take after they leave the hospital, he said.
So Ivy Fung was hired as a kind of hospital coach. She helps seniors get their questions answered. She also ensures that check-up visits are scheduled with their doctor.
Now, 60 percent of hospitalized seniors being monitored in the program have a scheduled doctor's appointment within 10 days after leaving the hospital - a significant jump from the 38 percent who had scheduled appointments before the program began.
The program also works with Providence Hospice and Home Care. Hospice nurses work side by side with medical staff at The Everett Clinic.
Steps can be taken so patients living at home are "being watched and their medical and social issues are being addressed," Lee said. Some 750 seniors who are Everett Clinic patients are now receiving services through this program.
The point is to provide help to these patients far sooner than when hospice typically gets the call for help - often about 19 days before a patient dies.
Most of these patients don't do well in the hospital, said Velda Filzen, program coordinator. "Often they are chronically ill and elderly. That can't be fixed in a hospital."
"We want to give extra attention and care," she said.
Volpe said she saw that in Filzen's visits with her father, Greg Garske, at his home in Everett.
"I felt like he had gotten the best care," Volpe said. "He was very independent and very determined to be independent.
"Encouraging them, giving (people) a sense that they're capable, is such a huge part of staying independent."
The lessons being learned from the project are important both now and in the future, said Rick Cooper, The Everett Clinic's chief executive.
Nearly one-quarter of its 275,000 patients currently are on Medicare. That number will only grow as baby boomers get older.
That's why the organization invested $1 million in the program, he said.
"We needed to learn more about how we could care for our seniors and improve the quality of care," Cooper said.
"I think it's a win for Snohomish County," Lee said, "a different approach to health care."
It is one of only 10 medical clinics nationally participating in the Medicare project. The federal program expects to spend $454 billion this year on medical care for seniors.
The challenge involves monitoring the health and medical care of 9,313 Medicare patients in the clinic's Stanwood, Marysville and Everett offices.
By the end of the project's first year, The Everett Clinic was able to treat its patients for $407,850 less that the cost of treating comparable types of patients at other area medical clinics, according to a Medicare analysis.
Its success, though, wasn't just measured in dollars and cents. Along the way, it won over patients such as 89-year-old Greg Garske of Everett, whom even his daughter described with a loving chuckle as "a curmudgeon."
"My father was not a big fan of our health-care system," said Carol Volpe of Seattle. "Going to the doctor was always a frustrating experience with him."
But the coordination among local health-care organizations that the Medicare demonstration project helped foster "allowed my father to be independent far longer than he would have," almost literally until the day he died earlier this month, Volpe said.
The program is "filling a niche that's a huge need and will grow as baby boomers get older," she said.
"There was such continuity with everything, and with our health-care system, that often isn't the case," Volpe said. "One hand doesn't know what the other hand is doing."
What made the difference was the time and attention her father received, Volpe said. "I didn't see other doctors give that kind of attention to and with that kind of detail with the elderly."
The Everett Clinic launched the program in April 2005. It is now in its third year. "We made it our goal to improve the care delivered to seniors in our community," said Dr. James Lee, an internist who is overseeing the Medicare demonstration program.
Patients are monitored for how well health problems, such as diabetes and heart disease, are managed and whether patients received regular health screenings, such as those for breast and colon cancers.
"We also were interested in looking at coordinating care between the hospital, nursing home and the clinic," Lee said, since many elderly patients "fall through the cracks" as they move from one of these health care settings to another.
For example, as seniors are discharged from the hospital, they often don't have a follow-up appointment set to see their doctor. And they're often confused about the instructions they get on what steps they should take after they leave the hospital, he said.
So Ivy Fung was hired as a kind of hospital coach. She helps seniors get their questions answered. She also ensures that check-up visits are scheduled with their doctor.
Now, 60 percent of hospitalized seniors being monitored in the program have a scheduled doctor's appointment within 10 days after leaving the hospital - a significant jump from the 38 percent who had scheduled appointments before the program began.
The program also works with Providence Hospice and Home Care. Hospice nurses work side by side with medical staff at The Everett Clinic.
Steps can be taken so patients living at home are "being watched and their medical and social issues are being addressed," Lee said. Some 750 seniors who are Everett Clinic patients are now receiving services through this program.
The point is to provide help to these patients far sooner than when hospice typically gets the call for help - often about 19 days before a patient dies.
Most of these patients don't do well in the hospital, said Velda Filzen, program coordinator. "Often they are chronically ill and elderly. That can't be fixed in a hospital."
"We want to give extra attention and care," she said.
Volpe said she saw that in Filzen's visits with her father, Greg Garske, at his home in Everett.
"I felt like he had gotten the best care," Volpe said. "He was very independent and very determined to be independent.
"Encouraging them, giving (people) a sense that they're capable, is such a huge part of staying independent."
The lessons being learned from the project are important both now and in the future, said Rick Cooper, The Everett Clinic's chief executive.
Nearly one-quarter of its 275,000 patients currently are on Medicare. That number will only grow as baby boomers get older.
That's why the organization invested $1 million in the program, he said.
"We needed to learn more about how we could care for our seniors and improve the quality of care," Cooper said.
"I think it's a win for Snohomish County," Lee said, "a different approach to health care."
Story tags »
• Everett • Marysville • Stanwood • Health organizations • Health treatment • The Everett Clinic • Elderly • MedicareAbout the Medicare test program
The Everett Clinic is one of 10 clinics nationally participating in a Medicare program to see whether the health care seniors receive can be improved while saving money.
The program involves 9,313 Medicare patients in Stanwood, Marysville and Everett clinics.
In the first year of the program, The Everett Clinic was able to treat its patients for $407,850 less than the cost of treating comparable types of patients at other area medical clinics, according to a Medicare analysis.
Here are some of the steps they took to cut costs while trying to provide better care:
The other physician groups participating in the project are Dartmouth-Hitchcock Clinic, Bedford, N.H.; Deaconess Billings Clinic, Billings, Mont.; Geisinger Health System, Danville, Pa.; Middlesex Health System, Middletown, Conn.; Marshfield Clinic, Marshfield, Wis.; Forsyth Medical Group, Winston-Salem, N.C.; Park Nicollet Health Services, St. Louis Park, Minn.; St. John's Health System, Springfield, Mo.; and the University of Michigan Faculty Group Practice, Ann Arbor, Mich.
Top 10 costs
Nationally, there are 44 million Medicare patients, including 853,000 in Washington. The federal government is expected to spend $454 billion for their care this year. Of Medicare's top 10 medical costs, eight are caused by chronic, or long-term, conditions.
Heart disease: 18.7 percent
Mental disorders: 14.6 percent
Trauma: 11.3 percent
Arthritis: 10.3 percent
High blood pressure: 10.2 percent
Cancer: 9.2 percent
Diabetes: 8.2 percent
Pulmonary conditions: 6.5 percent
High cholesterol: 5.9 percent
Diseases of arteries in the brain: 5.1 percent
Source: Health Affairs
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