Parkland’s new vCare model improves healthcare, lowers costs
Offers innovative, value-based care to most vulnerable patients
Between January and June 2016, the patient visited Parkland Memorial Hospital’s emergency room 86 times. If that sounds like a lot, Parkland officials say, it is — ¬but this patient is not unique. Across the nation, millions like him contribute to overcrowding and inefficiency in hospital emergency rooms. Known as ‘super-utilizers,’ they are people with a variety of difficult social and medical problems who visit ERs for care that often could be provided more efficiently in a primary care setting.
U.S. hospitals, eager to cut down on long ER wait times, improve the quality of care and increase patient satisfaction, are looking for ways to improve access to appropriate outpatient care for ER super-utilizer patients. Parkland officials believe they may have found one. It’s called vCare, an innovative value-based care delivery model that Parkland launched in October 2016. The program is designed to provide customized care for highly vulnerable patients while also lowering utilization of more costly acute care services.
“Value-based care is emerging as a way to address rising healthcare costs, inefficiencies like duplication of services and improve quality,” said Esmaeil Porsa, MD, Executive Vice President and Chief Strategy and Integration Officer at Parkland. “ER super-utilizers pose a significant challenge to health systems. We developed vCare to identify and work with existing patients in our Community Oriented Primary Care (COPC) health centers who are using ER services at a high rate. The idea is to link them to a multidisciplinary team in their COPC health center to provide medical and social services they need in an individualized and patient-centered way.”
According to Muhammad Nasir, MD, Senior Lead Staff Physician at Parkland’s Bluitt-Flowers Health Center, “Each COPC multidisciplinary team includes a primary care physician, RN, case manager (social worker) and medical assistant who provide preventive and episodic care, disease management and health maintenance services for the patients assigned to the program. Our goal is to close care gaps so patients’ needs are met on a real-time basis and reduce their dependency on going to the ER for services.”
The program also engages the patient’s family to identify unique needs and help implement personalized care navigation plans. Each patient is closely monitored to determine if their medical needs are being met and plans are modified as needed.
During the pilot phase of vCare, Parkland identified three to five established patients at each COPC site with cumulative visits to Parkland’s ER of more than 500 times in a 12-month period and contacted them to find out why they sought ER care so frequently. Parkland vCare interventions begin with a psychosocial assessment. Patients are educated on the importance of preventive and primary care. They also receive assistance with needs ranging from bus fare to medication refills, help scheduling appointments and referrals for housing assistance or other social services.
During the first month of vCare intervention, the “86-visit patient” came to Parkland’s ER nine times. In the next six months, he was seen at the ER only three times. Another super-utilizer patient who sought care at Parkland’s ER more than 200 times last year has visited the emergency room only once in the past six months, thanks to vCare assistance.
Under vCare, three to five new super-utilizer patients are identified at each of Parkland’s 12 COPC health centers and receive intensive care management customized to their needs for 90 days. At the end of the 90-day period, depending on the success of the interventions, an additional three to five new patients are identified at each clinic for the next vCare patient intervention group.
“We are extremely pleased that vCare is making a positive difference in the lives of these patients and their families,” Dr. Porsa said. “vCare meets Parkland’s best-practice process standards and is positively impacting quality, safety, cost and performance while also improving the family and patient experience.”
For more information about Parkland services, please visit www.parklandhospital.com.
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