In the NFL, teams always look for that quarterback who can get the ball over the goal line. In the health-care game, the go-to player is the primary care physician.
But like the quarterback, the primary care doctor needs a good team around him – which is the concept behind Sharon Regional’s Primary Care Resource Center. Unveiled Wednesday, the center is designed to improve care for targeted patients released from the hospital and reduce the chances of them being readmitted.
Funding for the project came from the Patient Protection and Affordable Care Act, better known as Obamacare. Money was funneled through the Pittsburgh Regional Health Initiative, a non-profit organization that has a goal of improving healthcare in western Pennsylvania. The group received a $10.4 million federal grant to create centers throughout the region, and Sharon Regional was among the six community hospitals chosen.
PRHI said it expects to save $41 million in Medicare costs alone during the three years of the grant.
“Basically, it’s a home base,’’ said Dr. Keith Kanel, PRHI’s chief medical officer and principal investigator for the project. “Many patients are discharged without understanding their illnesses or treatment plans. Hospital-based and community-based primary care physicians may not always communicate with each other to develop a coordinated post-discharge care plan for patients. Patients might not have the right prescriptions or be able to fill them or take the wrong doses.’’
Another problem that surfaces are patients may forget to make their follow-up appointments with their primary care doctor, he added.
Under the program, within 72 hours of being discharged from Sharon Regional a targeted patient will be contacted by the center. A center team member conducts a home visit and creates a home support plan for the patient and their family to follow. The idea isn’t to replace the primary care doctor – rather, to work in tandem with the doctor and other care givers the patient may have to prevent them from being re-admitted to the hospital.
There is a financial incentive in all of this.
Under the new law, Medicare can withhold up to 1 percent of regular reimbursements for hospitals that had too many patient readmissions within 30 days of discharge because of three medical conditions: heart attack, heart failure and pneumonia. The maximum penalty will increase to 3 percent by 2015 and be expanded to include readmissions for other medical conditions.
When considering the readmission rate nationally for heart failure is 25 percent – the savings potential here is huge. That’s why it wasn’t just on a whim Sharon Regional was among a number of western Pennsylvania hospitals seeking the designation, noted John “Jack’’ Janoso, Sharon Regional’s CEO.
“We were hoping and hoping to be a viable participant,’’ he said.
For more information on the Primary Care Resource Center, call 724-983-7336.