BY GEORGE CHRISTIDES, M.D. – As Chief Medical Officer for AppleCare Medical Group, an independent physicians association of 900 doctors serving Los Angeles and Orange counties, I have witnessed how collaboration and data sharing within the Blue Shield ACO model has enabled us to envision the new era in healthcare. The programs and initiatives we have developed have helped improve health outcomes for our entire patient population, not just our Blue Shield membership.
For more than a decade, AppleCare and Blue Shield have worked together to deliver care to patients. In 2014, we deepened our partnership by forming an ACO to provide care for Blue Shield’s commercial members.
Over the past two years, this ACO collaboration has enabled our physicians and staff to improve healthcare quality and affordability, leading to meaningful results and increased patient satisfaction. We have accomplished this by sharing data, clinical best practices and financial risk.
The unprecedented data sharing and transparency between our two organizations has led to new opportunities and efficiencies in our care delivery. The result? We’ve expanded services, enhanced existing programs and created new ones to help patients improve their health.
Here are a few examples of our collaborative work:
Transition of Care Program
This program provides several follow-up phone calls to patients after discharge from a hospital or skilled nursing facility to assess overall wellness, address medication issues, coordinate care and schedule home visits when necessary. The results are impressive: We’ve seen a dramatic reduction in readmissions within 30 days of discharge for our Blue Shield commercial membership.
AppleCare “Immediate Care Center”
This urgent care center is available exclusively to AppleCare patients and it is open evenings and weekends offering a $0 copay to commercial members. The AppleCare Immediate Care Center has proven successful with a high volume of visits, correlated with a significant reduction of emergency room visits. We credit the immense success of the Immediate Care Center to targeted marketing and $0 copay.
ACO Pharmacy Program
Our patients can now consult an AppleCare pharmacist to help manage treatment with prescription medications, addressing a wide range of issues including: strategies to remember to refill and take routine medications that treat chronic conditions, how to manage side effects, and effective treatment options that minimize out-of-pocket costs.
The pharmacists may also order medication-related lab tests, review results and adjust dosing if needed. Management of medications is now enhanced by the expertise of a pharmacist, and there is more time for patients to discuss their treatment.
We will soon rollout a new mobile technology pilot program that utilizes Blue Shield data to help our physicians identify new patients with diabetes and patients who are starting anticoagulant therapy (such as Coumadin), and readily communicate with AppleCare pharmacists for better-coordinated care of those patients.
These patients can be quickly scheduled with an AppleCare pharmacist for education and management of diabetes, and to monitor anticoagulant therapy to prevent bleeding events.
“We have received positive feedback from patients as well as our physicians and look forward to integrating technology to further improve patient outcomes on a larger scale,” AppleCare pharmacist Katherine Le told me.
The focus of our ACO has been to improve care to all patients by enhancing the care management system, and our efforts are making an impact. Plus, with more of our local residents coming to see us (17 percent growth in 2015), we’re now building a second Immediate Care Center, which is scheduled to open later this year and will focus on senior wellness and chronic care management.
Based on AppleCare’s experience and the ACO results we have achieved in the past two years, it is no surprise to me that Blue Shield’s ACO program is a nationally recognized model that’s making an impact in our local communities.
George Christides, M.D., is chief medical officer of AppleCare Medical Group