Howell clinic rolls out new model for primary care

BlueSky Health has plan for $30 a month

“If someone has a sore throat, they can take a picture of their sore throat, send us a text, and we can
potentially treat it just that way,” Valenti said. “But if they do need to come in and see us, we can generally
see them same day or next day.”

While BlueSky Direct currently is being sold to and used by individuals, Valenti said the goal is to
collaborate with employers, unions, municipalities and insurers — and save everyone money in the long
run.

Preventive care and disease management, he said, are key components to a quality primary care product.
“When you buy coffee, you want it to be hot and you want it to taste good. We’re saying to any employer
or individual or any payer to hold us to two criteria: Have we kept you out of the emergency room, and
have we kept you out of the hospital? If we’ve done those two things, then we’ve done our job,” Valenti
said.

BlueSky Health opened its Howell clinic in April 2012. It’s other clinic in Houghton was founded in 2006 by
Dr. Jeff Huotari, the company’s CEO.

The Howell clinic is the launch pad for its direct primary care model, which Valenti said isn’t being
provided anywhere else in Michigan on a grand scale.

“It makes a lot of sense to us; it’s just a matter of getting the word out,” Valenti said.
To enroll in BlueSky Direct, patients pay a six-month minimum upfront but can cancel at any time after
that.

For more information about BlueSky Direct, call 517-545-2400 or 888-288-0201,
or go to http://www.blueskyhealth.org/ bluesky-direct.

http://www.livingstondaily.com/article/20131229/NEWS01/312290012/Howell-clinic-rolls-out-new-model-primary-care

Kroger's Little Clinic to collaborate with UC Health on patient care

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Courtesy UC Health

UC Health and Kroger's The Little Clinic announced a new partnership on Tuesday.

“Kroger is an iconic company deeply rooted in Cincinnati, and we look at the association with The Little Clinic as a tremendous opportunity,” said Jim Kingsbury, president and CEO of UC Health, which is affiliated with the University of Cincinnati.UC Health announced Tuesday that it will expand its brand – and perhaps its patient base – through a collaborative agreement with The Little Clinic medical centers inside 18 Kroger grocery stores throughout Greater Cincinnati.

If a patient agrees and signs a waiver, The Little Clinic and UC Health will exchange medical records. That is expected to enhance the level of care that patients of UC Health will be able to receive at The Little Clinic, which accepts most health insurance plans.

In addition, doctors at UC Health will be able to provide advice to the nurse practitioners and physician assistants who diagnose and treat patients at The Little Clinic. And people who go to The Little Clinic for medical care could be referred to primary care doctors or specialists at UC Health.

The clinics are open every day and evening, and no appointment is necessary. Availability to health care inside Kroger stores on evenings and weekends is expected to help reduce visits to the emergency room by patients, according to UC Health, which includes the University of Cincinnati Medical Center, West Chester Hospital and University of Cincinnati Physicians (more than 700 board-certified clinicians and surgeons).

“This collaboration allows patients greater access to health care close to home and work,” said Dr. Ken Patric, chief medical officer for The Little Clinic. “One of our goals is to provide convenient monitoring for those who struggle with chronic care management such as diabetes. Offering a convenient place for routine examinations and supervision of such conditions will enhance compliance and improve outcomes.”

No financial consideration was paid by either company, I was told by Jennifer Martin, a spokeswoman for The Little Clinic.

The Little Clinics in Kroger stores in Northern Kentucky won’t be part of the collaboration because of differing state regulations, Martin said. The Little Clinic has 107 locations inside Kroger stores in Ohio Kentucky, Tennessee and Georgia; King Soopers in Colorado; and Fry’s Food Stores in Arizona.

“We hope the relationship with the Little Clinic grows beyond the ... locations currently in Cincinnati and Dayton,” said Peter Iacobell, UC Health’s vice president of strategic planning and development. “Both organizations are working closely together, and we’re not going to disclose any financial arrangements. ...

“The Little Clinic is a great partner, and we believe we are positioned to assist them in providing great care to their patients,” Iacobell said. “We’re just beginning to explore and understand the true potential of this relationship.”

Forging such collaborations has become a trend, and The Little Clinic has similar arrangements with health systems affiliated with Ohio State University and the University of Louisville, Martin said.

Developing relationships that improve access to specialized health care throughout the region and nationally is one of UC Health’s strategic initiatives, Kingsbury said.

“We believe this relationship will place both organizations on the forefront of a new care delivery model,” said Dr. Myles Pensak, CEO of University of Cincinnati Physicians. “Health care is evolving, and so is UC Health.”

The collaboration won’t involve creating new jobs or replacing staff at The Little Clinic locations in Greater Cincinnati, Martin told me.

Those nurse practitioners and physician assistants at the local clinics diagnose and treat minor injuries and illnesses, including cuts, allergies, colds, sore throat, ear and sinus infections. They can prescribe medications, conduct tests and interpret laboratory results, provide wellness and preventive care, perform physical examinations and health screenings, and administer vaccinations and injections to adults and children 18 months or older.

A wholly owned subsidiary of Kroger, The Little Clinic has its corporate office in Nashville, Tenn. CEO Mike Stoll spent 34 years with Cincinnati-based Kroger, most recently as Kroger’s vice president of corporate benefits. The first Little Clinic opened in a Kroger store in Louisville in 2003, and Kroger bought the company in 2010.

For a complete list of locations:

http://www.bizjournals.com/cincinnati/news/2013/11/05/krogers-little-clinic-to-collaborate.html?page=all

Mobile health vans' value proposition

Posted on Sep 13, 2013

By Tammy Worth, Contributing Writer

Hospitals that utilize mobile health vans will tell anyone that bringing needed services to people in underserved areas improves population health, but with accountability and cost effectiveness increasingly important, there is a need to understand the potential financial return on this kind of service.
While no one doubts that the vans bringing primary care or focused services like dental care or preventive screenings do so for no cost or very low cost, there is not a lot of data available to pinpoint just how valuable the mobile health service is to hospitals.
Part of the challenge with determining the return on investment of mobile health units is inherent to their use. Unlike most hospital services, the goal of mobile health is to find and care for people who can’t pay for treatment.
“St. Joe is very mission-based and we are looking for people who are low-income, uninsured and would otherwise not be able to access this kind of care,” said Dana Codron, executive director of community outreach at St. Joseph Health in Napa, Calif.
St. Joseph invests $5 million annually in mobile health clinics, about 11 percent of which is offset by reimbursements. Their mobile dental clinics, which cost about $650,000 annually to operate, are reimbursed better and see about 60 percent of costs returned.
“We anticipate a loss but we do believe it is possible to generate revenue and meet expenses if the target population is better insured,” Codron said.
Southcoast Health System’s mobile health system is also in the red, but the vans, which serve communities in southeastern Massachusetts and East Bay, Rhode Island, fill a void in those communities, said Kerry Mello, community benefits manager for the organization.
“If we put an article in the paper saying we were doing free screenings, we would get few people to come out,” she said. Having the mobile health vans allows the nonprofit hospital to go directly to the people in their communities, potentially saving lives and money down the road.
Many nonprofits like Southcoast and St. Joseph have funds set aside for mobile vans as part of their community benefit requirements.
At St. Joseph, 10 percent of net revenue and 1.5 percent of the operational budget is linked to services that care for underserved populations, Codron said. They also receive grants to offset some of the costs of the vans. Many mobile health units rely upon this kind of mixed funding for operations.
Part of the challenge of funding mobile health vans at for-profits is that, as an accounting line item, the units don’t make money. Similar to the argument for preventive services in general, the cost savings are indirect. There is an assumption that mobile units will reduce the instance of emergency room visits and keep chronic conditions from advancing to the degree where patients need higher-cost care.
Though the numbers on savings related to prevention are drastically varied depending upon their source, Trust for America’s Health has shown a return of $5.60 for every $1 spent on prevention. This is mostly found in reducing rates of diseases that can be caused by poor lifestyle habits including type 2 diabetes, high blood pressure, heart disease and some cancers.
Some groups have tried to quantify the return on investments on these mobile health units and their calculations are positive.
“We had to prove that they aren’t just improving health, but there is a financial benefit, too,” said Jennifer Bennett, executive director of the Family Van program based at Harvard Medical School.
Bennett and colleagues worked with a formula to understand the financial viability of mobile health vans. The return on investment is equal to the value of the van divided by the annual cost to run it (i.e. emergency department costs avoided plus the value of life years saved from the services provided).
Based on data provided in 2008 from Boston vans, they figured that the saved cost of emergency visits was more than $3 million and the value of providing preventive services was approximately $20 million a year. The cost to run the program was $567,700. The ROI was $36 for every $1 spent.
Another program, a group of mobile asthma clinics called the Breathmobile, provides free care to underserved children in different cities across the nation. A study of Breathmobile use in Baltimore found that after a year in the program, $79.43 was saved for patients each day they were symptom free. A study of Breathmobiles in California found an ROI of $6.73 per $1 invested. They added the emergency room costs avoided and the value of quality-adjusted life years saved and divided it by the cost of the program, which was approximately $500,000 a year.
One of the reasons the cost benefits are so high is that the mobile clinics tend to serve high-risk populations that are high users of emergency departments, Bennett said. One question her group asked when they were creating the study was what patients would have done if they hadn’t visited the Family Van the day they did. Fifty-four percent said they would have gone to an emergency room.
“The establishment benefiting the most is not the Breathmobile itself in terms of dollars, but it is going to be the public health insurance system,” said Tricia Morphew, an analyst for Breathmobile. “They are able to spend less in emergency department and hospital visits.”

http://www.healthcarefinancenews.com/news/mobile-health-vans-value-proposition