Changing the healthcare paradigm has always been part of the fabric of the John C. Lincoln Health System (JCL) in Arizona, and today they continue their visionary work. JCL has recognized that military medics have been saving lives on the front lines all over the world where the United States military is engaged, and is leveraging their talents to help design a new healthcare delivery system.
Nathan Anspach, CEO of Phoenix-based John C. Lincoln Health Network's Accountable Care Organization (ACO), saw military medica as a potentially transformative force, a Medicare healthcare corps. While gaining their medical credentials in the U.S., Anspach recognized that former military medics can be instrumental in helping design and implement strategies to aid the legions of frail Medicare recipients in managing their healthcare. Anspach's vision was to employ this healthcare corps to stop the revolving door of hospital readmission for Medicare patients. To accomplish this, he created a three-pronged strategy:
First, focus on "preventable readmission" of the frail elderly who are discharged from hospitals. By monitoring vital signs and getting needed medications, costly readmission to a hospital or emergency room can be avoided;
Second, work with these patients to ensure they get services needed to maximize their independence. This will keep them out of nursing homes;
Finally, serve as personal healthcare advocates. Healthcare corps members can answer questions to help Medicare patients navigate the discharge process and beyond.
Anspach and his colleagues recognized that the future of heathcare - Medicare in particular - is based primarily on the ability to create and implement innovative solutions that treat and manage the care of frail elderly patients. A management plan starts by helping Medicare patients understand instructions from their medical team, then moves on to managing their medications. But, it doesn't stop there. A seamless recovery includes active daily intervention of a healthcare worker who serves both as the Medicare patient's care transition coach and a lifeline to the outside world.
An absence of coordinated-care transitions leads vulnerable Medicare patients back into an ER or a nursing home. Because these fragile patients often see multiple physicians, there is a heightened possibility of medical errors, duplication of services, increased costs and haphazard care. Military medics skilled in war zone medical care are trained multi-taskers who are ideal for preventing care fragmentation.
The Lincoln ACO Plan has had an immediate and remarkable impact at JCL.
Since the program was implemented in October 2012, 309 frail Medicare patients have been discharged and only 5 (or 1.62 percent year to date) have been readmitted. For this same time period last year, 64 (or 20.7 percent) people were readmitted.
The Centers for Medicare and Medicaid Services has published tables on the three most frequent conditions for readmission:
Condition Readmission rates nationally Lincoln Plan
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Heart failure 24.7% <1%
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Heart attach 19.7% <1%
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Pneumonia 18.5% <1%
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At a time when one in five Medicare beneficiaries discharged from the hospital is readmitted within 30 days, costing an estimated $12-17 billion annually, the value proposition of the John C. Lincoln program is an extraordinary beginning.
Creating a solution to aid the frail elderly by employing talented and dedicated former military medics underscores that the Medicare revolving readmission door can be slammed shut. Imagine implementing the Lincoln ACO Plan in every state.
As foundations and corporations look for pioneering and successful strategies to change the standard of care in the U.S., they should begin by understanding the John C. Lincoln ACO strategy.