PRESIDENT/CEO CRAIG LEACH EXPLAINS HOW IMPROVED COORDINATED CARE BENEFITS THE HOSPITAL’S PATIENTS AND PHYSICIANS.
With so many unprecedented changes occurring in the delivery of our nation’s health care, it can feel a bit daunting. We’ve all read in the news or overheard our friends and neighbors talking about the Patient Protection and Affordable Care Act and the related launch of the Insurance Exchange on October 1. But honestly, most of us are still apprehensive because we have one important question on our minds: What do these changes mean for me and my family?
Torrance Memorial Medical Center recently introduced the community to the Torrance Memorial Health System to facilitate the management of patient outcomes and the experience of the population served by the Torrance Memorial family. This new system will help patients navigate the changing health care landscape.
Pulse sat down with Craig Leach, president/CEO of the newly named Torrance Memorial Health System, to give you answers to your pressing questions about health care reform, the hospital’s approach to coordinated care and the future of your health and wellness needs.
PULSE:Is the Affordable Care Act the catalyst for the changes in health care we are experiencing today?
CL: Actually, while some changes were initiated by the Affordable Care Act, many were brought about earlier by the Centers for Medicare and Medicaid Services (CMS). One change that will have a positive impact on health care is the push toward transparency of quality and cost information. So while Torrance Memorial already tracks and reports the health outcomes of our patients to ensure continuous improvement and implementation of new evidence-based protocols, CMS is comparing the hospital’s quality and cost information, incentivizing hospitals to provide improved value to consumers.
PULSE:Can you explain the Health Insurance Exchange and California’s version—Covered California?
CL: As part of the Affordable Care Act, the federal government developed a health insurance access model called the Health Insurance Exchange where individuals who do not have health insurance, or want a different plan than they have today, can price shop a variety of plan options before they purchase health insurance. The California version of this exchange is called Covered California. Physicians and hospitals have contracted with insurance plans selling insurance on the Exchange. Patients who review plan options also have the ability to explore subsidies meant to help underwrite their monthly premium.
PULSE:I’m in the process of shopping for new insurance. Which plans are the hospital and other physicians on staff at the medical center contracted with?
CL: Within the Exchange, most South Bay physicians are contracted with Anthem Blue Cross. The hospital is contracted with Blue Shield and HealthNet as well.
PULSE:Torrance Memorial introduced the Torrance Memorial Health System to facilitate and improve the care of its patients. Why is your organization’s name change significant?
CL: Torrance Memorial Medical Center and its provider partners have worked for nearly 90 years to be available when our residents need great health care. That has not changed. What is different is that with the introduction of the Torrance Memorial Health System, we bring a new level of service to further improve the health of South Bay residents. This broad yet highly coordinated strategy is guided by an organization that is locally-based and understands the needs of our community. We remain true to our mission of providing compassionate, high-quality medical care at every point in the organization.
PULSE:Can you provide an example of how a patient might benefit from this increased integration?
CL: More than two years ago we saw the growing need for more primary care physicians and certain specialists to manage, and hopefully reverse, disease associated with chronic conditions such as diabetes, cancer and autoimmune issues. To meet this need, we established the Torrance Memorial Physician Network, which today includes more than 40 physicians coordinating the care of thousands of patients. By working within one group synchronized to provide care, they are able to utilize the resources of the Torrance Memorial Health System to not only manage health conditions but improve health.
Because of integrated technology, primary care physicians can closely track the care that specialists in the network provide, such as a recommendation for a new medicine or test. In the past, it was somewhat challenging to ensure that a patient’s personal physician knew when he or she saw a specialist and what was recommended. Today, within the network, the use of an electronic medical record assists in keeping everyone on the same page. The structure encourages communication and reduces inefficiencies, allowing physicians to get back to what they love— practicing medicine for their patients’ benefit.
PULSE:What do you mean inefficiencies? I like the way I received care in the past.
CL: Unfortunately, health care in the United States is expensive relative to other countries. Our goal is to provide care in a coordinated and integrated fashion with physicians throughout the Torrance Memorial Health System to reduce the duplication of tests, or inefficiency, contributing to the overall expense of health care.
PULSE:A moment ago you mentioned that there are more ways to help patients manage disease associated with chronic conditions such as diabetes, cancer and autoimmune issues. How does that work?
CL: To help patients manage their health and to better guide them through their hospitalization, the Torrance Memorial Health System has developed the Total Wellness Torrance program. Hospital staff fulfill the program’s mission by working to 1) educate patients and provide resources before and after they are discharged from the hospital to teach self-management and 2) evaluate patients who re-visit the hospital’s Emergency Department after their initial stay to help them seek alternate levels of care to prevent unnecessary re-hospitalization.
Health care reform encourages hospitals to work with patients to avoid unnecessary hospitalizations through a provision in the Affordable Care Act that requires a closer partnership with patients—specifically those who have had heart attacks, heart failure, pneumonia, COPD and joint replacement. The provision seeks to ensure hospitals provide proper care at critical times in a patient’s recovery from surgery and through improved management of chronic conditions.
PULSE:It sounds like patients are receiving more than what we once thought of as traditional hospital medicine.
CL: Care providers have always been dedicated to improving their patients’ health. This program builds on that by assisting patients once they leave the medical center. It was designed to ensure that patients are safe and comfortable in their living environment and to eliminate any confusion related to medications, social issues or continued care needs. Through this program an ambulatory (outpatient) case manager collaborates with home health, hospice and skilled nursing care facilities after discharge to educate and guide patients through their post-hospital care plan.
One component of the program is the hospital’s Post Acute Network, a collaboration of locally preferred skilled nursing facilities within five miles of the hospital committed to working to prevent unnecessary re-admissions. Social workers coordinate with patients who are discharged from a skilled nursing facility to schedule follow-up visits at Torrance Memorial Health System’s Care Coordination Center (on Hawthorne Boulevard). The more the care team can stay in communication with each other and our patients, the better opportunity we have to keep our patients well even when they are not hospitalized.
It may take years to achieve the model that we are moving toward, but the Torrance Memorial Health System is laying the foundation as new programs are implemented to improve the coordination of care and the health of the community we serve.