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Friday, Dec 8, 2023

Health: Hospitals, clinics work to prepare for new stream of patients.

Some local health care providers are staffing up and expanding services to make way for an influx of new patients they say will seek primary care. Officials with Mission Community Hospital, Valley Community Clinic, Northeast Valley Health Corporation and Kaiser Permanente Southern California say they expect to see a change in their patient demographics, especially as a result of federal health care reform. While it’s still too early to know the impact of the federal government’s Patient Protection and Affordable Care Act — which was passed last year and takes effect in 2014 — officials say they must begin preparing now. Jim Lott, executive vice president of the Hospital Association of Southern California, said the new law will shift demand from emergency services to primary care. That’s forcing local health care providers to partner with more physicians and add resources for outpatient services. The new law is also causing hospitals and physicians to garner new types of partnerships, he said. “With or without health care reform, we’re in a new day, and hospitals and doctors are going to have to change the ways they’ve been working — or not working — together in the past,” Lott said. Nationally, about 32 million uninsured Americans will have access to health coverage, according to HealthCare.gov, a website managed by the U.S. Department of Health & Human Services. The law also calls for providers to offer more affordable health care while also providing better outcomes. Preparing for the future Mission Community Hospital has already implemented some changes in anticipation of those newly insured patients, as well as more baby boomers entering the Medicare system, said Heidi Lennartz, the Panorama City-based hospital’s CEO. She said the hospital has added more than 90 additional primary care and specialist physicians to its staff over the past year, which is a much higher than its usual physician increase. The hospital now has more than 270 physicians, she said. “We’ve been organizing around the concept that (health care reform) will have an impact on providers,” Lennartz said. The hospital is also boosting its focus on orthopedic care. About a third of its new doctors are orthopedic specialists, she said. As for in-patient care, Mission Community Hospital is renovating one of its patient towers, which will add 25 more beds, she said. Valley Community Clinic is also preparing to ramp up its operations. The North Hollywood-based clinic also recently started participation in Los Angeles County’s Healthy Way LA program, designed to help facilitate the transition to health care reform. The program provides health care for uninsured low-income residents, residents with chronic conditions, and residents nearing the Medicare-eligible age, who have been using the county’s services in a frequent but uncoordinated way. “It’s kind of the bridge to health care reform, and we’re taking it on with the goal of increasing — doubling our capacity by 2014,” said Judi Rose, the clinic’s vice president of development and government affairs. Valley Community Clinic has committed to enrolling up to 7,000 patients over the next two years and up to 11,000 patients within the next three years, Rose said. To prepare for the new wave of patients, the clinic has recruited four new enrollment workers, Rose said. The clinic plans to start building several new exam rooms and behavior treatment rooms in the next couple of months. There are also plans to add more primary care physicians and mental health specialists and expand clinic hours. • 7 million residents are uninsured • 4.6 million uninsured to receive coverage through Medi-Cal or California Health Benefit Exchange subsidies in 2014 • 1.2 million additional uninsured won’t get subsidies, will have access to the exchange • 1 million uninsured to qualify for neither Source: UCLA Center for Health Policy Research, February 2011 policy brief (based on 2009 California Health Interview Survey) San Fernando-based clinic operator Northeast Valley Health Corporation is also participating in Healthy Way LA and preparing for health care reform in other ways, said Kim Wyard, the organization’s CEO. The organization recently announced some specific objectives for this year. Some of those include expanding its Santa Clarita Health Center, opening a new dental center with the Los Angeles Unified School District at its Sun Valley Health Center and relocating its Mission College Health Center to a larger location on campus. Wyard said her organization is also working on extending its clinic hours. Jim Anderson, a spokesman for Kaiser Permanente Southern California said the hospital system plans to increase capacity and physicians at its facilities in the future. However, it is too early to determine when that expansion will occur and by how much, he said. Collaboration Hospitals are also changing the way they collaborate with physicians, a key feature of the Affordable Care Act. “What you will see, and are seeing right now, is a rush to meaningful conversation between hospitals and medical groups about how do we can do better jobs of coordinating the care between hospitals and physicians,” said Bill Gil, president and CEO of Mission Hills-based Facey Medical Foundation, which foundation manages Facey Medical Group. The law specifically calls for improving the quality and efficiency of health care and lowering costs for patients using Medicare, Medicaid and the Children’s Health Insurance Program, according to HealthCare.gov. The law also plans out future financial incentives for hospitals achieving such goals, according to HealthCare.gov. There will be incentives for physicians who form “accountable care organizations” — or groups to better coordinate care and reduce hospital readmissions — and for hospitals and physicians who work together to charge bundled payments. Providence Health & Services is starting to better collaborate with its physicians to improve care, said Kerry Carmody, chief operating officer for the company’s Southern California region. Providence is working on its “clinical integration” model, which is a step beyond just the basic electronic health record system, Carmody said. The system involves collecting data, and analyzing it with the help of physicians and clinicians to determine how to make care more efficient and cost-effective. “We’re using data to redesign clinical processes,” Carmody said. “We’re using decision support services and physician analysis and nursing analysis.” Carmody said the system will be implemented at Providence’s pre- and post-hospital care services, in addition to its three hospitals in the San Fernando Valley. But while health care reform has its potential benefits, it also creates concerns, Gil said. Those include not having enough physicians to meet demand and uncertainty about what the payment model will look like, he said. Dr. Eyal Shtorch, a primary care physician and nephrologist at Mission Community Hospital, said physicians today already have to deal with delayed reimbursements and excessive “red tape” by government and private insurers. He’s hoping that will change. “We can take better care of (patients) if the new health care law allows us to be able to see these patients without a lot of bureaucracy,” he said.

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