Posts by madisol

Sutter Health and Alignment Healthcare Team Up in Northern California for Medicare Beneficiaries

Posted on May 14, 2019 in Expanding Access, Scroll Images

Not-for-profit health system and Medicare Advantage insurance provider seek to expand access to care and coverage, pending regulatory approval

SACRAMENTO, Calif.–Today, Sutter Health, a not-for-profit integrated healthcare system, and Alignment Healthcare, a Medicare Advantage insurance provider, announced the signing of an agreement that allows the two organizations to work together to offer more healthcare and insurance coverage options for Medicare-eligible residents in Northern California in 2020, pending regulatory approval.

Alignment has filed an application with the Centers for Medicare & Medicaid Services (CMS) to expand its Northern California service area. If the application is approved, Alignment and Sutter would begin offering new Medicare Advantage plans in the approved counties in October 2019 and members could seek “in-network” care with Sutter-affiliated and aligned physicians and facilities on Jan. 1, 2020.

“Sutter has a long history of launching new and innovative healthcare solutions for the benefit of patients and our communities,” said Phil Jackson, Sutter’s CEO of Health Plan Products. “This collaboration is designed to introduce new Medicare Advantage plans for eligible individuals and to help them shop for plans, find affordable coverage, and gain access to high-quality healthcare.”

Medicare Advantage plans are offered by private health insurance companies approved by CMS and must cover everything included in traditional Medicare — hospital costs, doctors’ visits and outpatient care. These plans often include extra benefits like prescription drug coverage, vision, dental and hearing exams. Every year, Medicare enrollees can review their health plan options in October and make changes to coverage beginning the following January.

Managed care delivery models such as Medicare Advantage make it easier for healthcare providers to coordinate care and practice preventive medicine, avoiding emergency room visits and more costly treatment plans. According to a study by the Boston Consulting Group[1], Medicare Advantage patients pay less in out-of-pocket costs than patients in traditional Medicare and, on average:

  • Are twice as likely to receive preventive care
  • Are half as likely to go to the emergency room
  • Go home from the hospital one day earlier
  • Are less likely to be readmitted to the hospital after discharge, and
  • Use fewer healthcare services, allowing providers to care for others in need

The Congressional Budget Office estimates that approximately 40 percent of all Medicare beneficiaries will be enrolled in Medicare Advantage plans by 2020.[2] Of the approximately 2 million Medicare-eligible residents in Northern California, an estimated 850,000 are currently enrolled in Medicare Advantage plans, according to CMS.

“The collaboration between Sutter Health and Alignment Healthcare is centered on our customers,” said Dawn Maroney, Alignment’s consumer president. “We are coming together to offer Medicare-eligible individuals in Northern California more choice, designing health plan products that will provide access and flexibility for specific population age groups in most of Sutter’s existing service areas in Northern California.”

Founded in 2013, Alignment Healthcare has created a model of healthcare delivery that combines high-touch care coordination with AVA®, its proprietary command center technology, to improve quality of care and eliminate waste in the care system. The central nervous system of Alignment Healthcare, AVA provides real-time reporting and predictive analytics that allow care specialists to anticipate care, often before it’s even needed. Now serving more than 60,000 members across three states, the Orange, Calif.-based company is supported by industry-leading investors and endorsed by influential parties including former CMS administrators and best-in-class hospital systems and health plans.

“Alignment is thrilled about this relationship with Sutter Health,” said John Kao, Alignment Healthcare founder and CEO. “By working together, we have the opportunity to offer more communities more access to care and implement population health strategies that improve care and lead to better health.”

 

[1] https://www.bcg.com/publications/2013/health-care-payers-providers-alternative-payer-models.aspx

[2] https://www.cbo.gov/sites/default/files/cbofiles/attachments/44205-2015-03-Medicare.pdf

Capital Public Radio Unveils Plans for New State-of-the-Art Headquarters in Downtown Sacramento

Posted on Apr 30, 2019 in Community Benefit, Scroll Images

Lt. Gov. Eleni Kounalakis, Sacramento Mayor Darrell Steinberg and Sacramento City Councilmember Steve Hansen Announce New Headquarters at 8th and J Streets

 

Sutter Health Provides Lead Investment Making Landmark Project Possible

 

Courtesy of Capital Public Radio

SACRAMENTO, Calif. — Capital Public Radio today unveiled its plans to move to a new state-of-the-art headquarters in the heart of downtown Sacramento and announced a significant investment from Northern California-based, not-for-profit integrated healthcare system Sutter Health. This collaboration signifies Sutter Health’s and CapRadio’s deep commitment to improving community health by creating a space that will function as both a journalism hub and a center for community engagement.

Sacramento Mayor Darrell Steinberg reveals the Sutter Health Center for Community Engagement during Tuesday’s event.

“We are proud to invest in this landmark project and provide the community with greater access to education, collaboration and community empowerment — important facets of a healthy community,” said Sarah Krevans, president and CEO of Sutter Health. “As an integrated, not-for-profit healthcare system, we have an important mission beyond the walls of our healthcare facilities to improve the overall health and wellbeing of the communities we serve. That’s why we invest in programs including those that provide shelter and resources to those who are homeless, increase access to mental healthcare and enhance our community.”

The new headquarters will be a center for news reporting, healthy civic dialogue and shared community experiences, while also contributing to the vitality and economic health of Sacramento’s downtown area. CapRadio will occupy the 34,000-square-foot facility at Eighth and J streets, allowing the NPR-member station to nearly double its staff to 140 members over time, and adding an estimated $4.8 million in wages per year. Sutter Health’s $2.25 million investment for CapRadio’s new headquarters will include the construction of the Sutter Health Center for Community Engagement, which has the capacity to host up to 220 people and as many 300 events per year, generating a potential economic impact of approximately $1.5 million for surrounding businesses in the area.

“With our move, we will add to the vitality and economic health of downtown Sacramento and we will be able to expand on our mission to inspire listeners to look at the world from multiple perspectives, learn from diverse audiences and engage our communities more broadly,” said Rick Eytcheson, president and general manager of Capital Public Radio. “We applaud Sutter Health’s recognition that our shared responsibility includes nurturing the mind and spirit, as well as the body. Sutter Health’s significant investment is making this move a reality, I couldn’t be more thrilled to work with such a committed community partner.”

CapRadio is licensed to California State University, Sacramento and is housed on the campus. Construction on the new downtown headquarters is slated to begin in late 2019 and is scheduled for completion in mid-2020.

Lt. Gov. Eleni Kounalakis, Sacramento Mayor Darrell Steinberg and Sacramento City Councilmember Steve Hansen helped celebrate the announcement at an event that featured a performance by the Sacramento Mandarins drumline, a banner drop to reveal a life-sized image of the entry to the Sutter Health Center for Community Engagement, and more than 100 guests.

“I am excited about this investment and not just because it is in my hometown. This investment reaches far beyond Sacramento and will have positive impacts for our democracy and freedom of expression,” said Lt. Gov. Eleni Kounalakis.

“Strong, credible journalism is crucial to our city and region, and I’m thrilled that Sutter Health’s investment will allow CapRadio to expand its coverage and be in the heart of downtown. This new center will also provide members of our diverse community a place to stay informed and achieve greater common understanding,” said Sacramento Mayor Darrell Steinberg.

“This state-of-the-art headquarters will soon be a destination that will add vitality to our city’s heart and support the creative economy of Sacramento’s downtown and our larger region,” said Sacramento City Councilman Steve Hansen. “As a CapRadio member, I’m elated to see the station put roots in our central city, which is at the crossroads of state and local news. Public radio continues to be the cornerstone of an informed public, and this new headquarters will be a beacon of civic engagement for the community.”

Sutter Health Supports Expanded Access to Telehealth in California Legislature

Posted on Apr 24, 2019 in Expanding Access, Scroll Images

Sutter Lakeside Chief Administrative Officer Dan Peterson was in California’s capitol voicing support for Assembly Bill 744, critical legislation that improves access to care through telehealth.

SACRAMENTO, Calif.–Sutter Lakeside Hospital Chief Administrative Officer Dan Peterson testified in Sacramento yesterday in support of California state Assembly Bill 744, by Assemblymember Aguiar-Curry, which Sutter Health believes is a critical step toward improving access to quality health care across California by ensuring that healthcare providers are adequately reimbursed for telehealth services.

Sutter Health is driven to continually transform health care – focusing on how, when and where consumers want and need health care services.  One way we are meeting patient needs is through the deployment of advanced telemedicine technology. Through the use of telemedicine we can bring high quality, around-the-clock care to patients who would not otherwise have access to specialists and specialty care.  We believe this is especially important for California’s rural communities.

At Sutter Health, we witnessed this firsthand when Lake County was devastated by a massive wild fire which left Sutter Lakeside Hospital – one of the only remaining health care providers in the county – closed for 14 days. Through Sutter’s integrated network we were able to remotely deploy physicians from parts of our network not impacted by the fires to digitally treat patients of the Lake County community – but we did so without knowing  if these providers would be reimbursed for their services.

Although current California law recognizes the practice of telehealth as a legitimate means for an individual to receive health care services, the language is insufficient to ensure that services are actually reimbursed.  As a result, health insurers may deny coverage to patients looking to benefit from telehealth services, patients are not assured that their insurance will provide coverage, and providers are unable to develop a sustainable telehealth program for the entire patient population.  AB 744 removes these barriers and will require health insurers to include coverage and reimbursement for services provided to a patient through telehealth.

Memorial Hospital Los Banos Awarded Advanced Certification for Primary Stroke Centers

Posted on Apr 11, 2019 in Quality, Scroll Images

LOS BANOS, Calif.—Memorial Hospital Los Banos has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s Heart-Check mark for Advanced Certification for Primary Stroke Centers. The Gold Seal of Approval® and the Heart-Check mark represent symbols of quality from their respective organizations.

“This is a very meaningful milestone for our community and our clinical care teams,” said Tushar Patel, M.D., medical director for stroke at Memorial Hospital Los Banos. “Our community can have confidence and peace of mind in knowing that exceptional stroke care is available here, thanks to the time and hard work invested by our staff.”

Memorial Hospital Los Banos, which is a part of Sutter Health’s not-for-profit, integrated network, underwent a rigorous onsite review last March. Joint Commission experts evaluated compliance with stroke-related standards and requirements, including program management, the delivery of clinical care and performance improvement.

“Memorial Hospital Los Banos has thoroughly demonstrated the greatest level of commitment to the care of stroke patients through its Advanced Certification for Primary Stroke Centers,” said Patrick Phelan, executive director, Hospital Business Development, The Joint Commission. “We commend their teams for becoming a leader in stroke care, potentially providing a higher standard of service for stroke patients in its community.”

“We congratulate Memorial Hospital Los Banos for achieving this designation,” said Nancy Brown, chief executive officer, the American Heart Association/American Stroke Association. “By adhering to this very specific set of treatment guidelines Memorial Hospital Los Banos has clearly made it a priority to deliver high quality care to all patients affected by stroke.”

Established in 2003, Advanced Certification for Primary Stroke Centers is awarded for a two-year period to Joint Commission-accredited acute care hospitals. The certification was derived from the Brain Attack Coalition’s “Recommendations for the Establishment of Primary Stroke Centers” (JAMA, 2000) and the “Revised and Updated Recommendations for the Establishment of Primary Stroke Centers” (Stroke, 2011).

Stroke is the number four cause of death and a leading cause of adult disability in the United States, according to the American Heart Association/American Stroke Association. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year. Memorial Hospital Los Banos’ certification comes just in time for May, which is National Stroke Awareness Month.

Changing the Face of Healthcare

Posted on Apr 2, 2019 in Community Benefit, Scroll Images

Memorial Medical Center CEO Gino Patrizio, Executive Director of Philanthropy for Sutter Health Valley Area Lisa Hume and Director of External Affairs for Sutter Health Valley Area Holly Harper report out about how their collective efforts support the Stanislaus County community.

MODESTO, Calif.–People may think of healthcare in terms of exam rooms and lab coats, stethoscopes and tongue depressors. Today, healthcare’s modern look features kids fitness classes, donations of healthy food items through mobile food banks or linking the homeless to wrap-around services like housing support, mental health services or addiction counseling.

The image of healthcare is changing—thanks to the teamwork between Sutter and various organizations in our Northern California communities.

During a recent gathering in Modesto, Memorial Medical Center CEO Gino Patrizio and Holly Harper, Sutter Health’s Director of External Affairs in the Valley, talked about how the health of our patients hinges on the health and well-being of their community. They hit on some highlights of how efforts inside and outside hospital and clinic walls supported the greater Stanislaus County in 2018:

  • In partnership with Sutter Health, Golden Valley Health Center’s Street Medicine Program delivers care to those who need it most. Last year, the street medicine program.
    • Served 2,083 individuals experiencing homelessness
    • Conducted 582 nurse assessments
    • Scheduled 70 primary care appointments
  • With support from Sutter Health, Second Harvest’s Mobile Fresh for Kids program made a tremendous impact at Shackelford Elementary School in the first half of 2018:
    • Served 651 children and youth
    • Distributed 48,503 pounds of food and 5,859 nutrition education handouts
    • More than half of parents whose children participated reported increased nutritional knowledge and preparation of healthier meals

Overall, Sutter invested more than $56 million to the underserved through charity care, unreimbursed costs of Medi-Cal and other community benefit support in 2018. This included nearly $1.1 million toward community partnerships that improve the quality of life for those in Stanislaus County. Working with 15 community partners, the programs served more than 43,000 adults and youth in neighborhoods throughout Modesto and all of Stanislaus County. Additionally, it provided more than 104,000 services to the community, including primary care appointments, school wellness activities, transportation and more

“With our community partners, we are always looking for innovative ways to expand access to care, helping to link patients to critical health and social services,” said Harper.  “We couldn’t do this without the help of community partners and feel fortunate to have the opportunity to collaborate with such innovative, creative and dedicated individuals, who are all working toward common goals.”

Many of the community investments stem from direct feedback from residents. Every three years, Sutter Health conducts Community Health Needs Assessments (CHNA) to determine the unique needs and challenges for each community Sutter supports and serves. Using both qualitative and quantitative data collection and focus groups, the CHNA report helps us identify this region’s communities of concern by zip code and the health needs of highest priority. The 2019 CHNA is now underway across Sutter Health.

For more information about Sutter’s investment into Northern California communities, visit Sutter Health’s Community Benefit page.