Calif. group envisions multifaceted care continuum to improve transitions
by Larry Beresford
Apollo Medical Holdings of Glendale, Calif., which provides hospitalist services in 24 California hospitals, recently took a step toward expanding its business model and diversifying its continuum of services by acquiring Los Angeles-based Aligned Healthcare Group, a provider of physician call centers and specialized care management services for health plans.
Call centers provide patients in the community with telephonic access to physicians and other health professionals for help with urgent medical questions, health assessments, and triage. The Aligned call center was developed in 2009 at the request of Anthem Blue Cross, which wanted to provide an ED alternative for its Medi-Cal members who needed access to a physician, explains Bette Jane Reese, RN, MHA, COO of Apollo's Aligned Division.
Apollo's care continuum will include follow-up calls to recently discharged patients, post-discharge calls to PCPs, and early discharge planning. The model partners a hospitalist with a care management nurse; together, they function as a virtual team across settings.
The acquisition gives Apollo a leg up on developing a continuum of care management across settings, she adds. "I believe enhanced hospitalist models will be a trend. As healthcare revenues become tighter, with more entities coming together in what's called accountable healthcare, the name of the game is coordination between settings and providers," she says.
Experts have emphasized the importance of hospitalists looking beyond the four walls of their facility and participating in "cross-continuum teams" as a key to managing care transitions and preventing rehospitalizations. Apollo hopes its new collaboration will help eliminate communication breakdowns between hospitalists and PCPs, Reese says. "By merging these functions, we get a combination of efficient hospitalist care with a bridge to the next setting, and coordination with multiple payer entities. It all wraps around the integrated hospitalist model."
HM's future in Apollo's model might include staffing outpatient clinics located on the hospital campus for patients to return for follow-up care after they are discharged, or even making home visits for patients who need additional medical oversight. "We see the issues and problems that cause patients to go back to the hospital," Reese says. "We can suggest quality improvement approaches to address the root causes of avoidable readmissions."
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