Program Finds Dedicated and Coordinated Efforts Improve Care for Seniors

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The Los Angeles Jewish Home two year program uncovers several key findings regarding the effectiveness of the medical home model of care for independent and assisted living residents

“We inherently understand that medical home care can reduce costs while improving quality and efficiency. We developed a program that clearly resonated with residents and those caring for them, producing a model that can be replicated across the county,” said Dr. Noah Marco, BRI Executive Director.

A medical home care program found that having a single accessible point person to contact when there is a need is key to better care for seniors. While this may not sound surprising, a recent two year medical home pilot study conducted by the Los Angeles Jewish Home (LAJH) through its Brandman Research Institute (BRI) uncovered several surprising outcomes based on a simple formatted healthcare delivery system.

“We inherently understand that medical home care can reduce costs while improving quality and efficiency. This is done through innovative approaches to delivering comprehensive patient-centered preventive and primary care. With this goal in mind, we developed a program that clearly resonated with residents and those caring for them, producing a model that can be replicated across the county,” said Dr. Noah Marco, BRI executive director.

In 2016, the LAJHwas awarded a $250,000 two year grant from the Jewish Foundation to evaluate if the medical home principles applied to independent and assisted living residents could improve outcomes by reducing falls, emergency department (ED) visits and hospitalizations.

LAJH-BRI created a program specifically to evaluate the outcomes of the grant. Over the course of two years, the Medical Home project evolved into the Concierge Medical Model. The key to the program was that each participant had a point person(s) to facilitate their medical and non-medical requests.

The original cohort was 50 participants, average age 87. After the first year, 45 residents remained; at the completion of the study, 36 participants were still enrolled. The participant ages ranged from 68-103.

Medical Home participants demonstrated better health outcomes at a lower rate of cost, including 10% higher rate remaining in their current level of care; 24% reduction in hospitalizations and a 75% reduction in clinic visits.

Key findings:

  • Demonstrated participants had a lower rate of hospitalization (35%) than the control group (46%),
  • Medical Home participants were able to stay in the same level of care after two years (72%) at a higher rate than the control group (65%).
  • Clinic visits were reduced by 75%, from 60 (2017) to 16 (2018). The findings concluded the single point of contact ‘open door policy’ that was observed was the most impactful for the reduction.
  • A licensed vocational nurse (LVN) provided 500 room visits over the course of the second year, averaging 5-8 visits a day. She provided numerous non-pharmaceutical interventions which dramatically impacted the quality of life for the participants.

The participants were able to drop into their assigned contact’s office without an appointment. They could ask a question, and get simple clarification or answers to their concerns were given. Patient education was provided in an informal setting which alleviated the need to make a clinic appointment to have their needs addressed.

In concluding their findings, LAJH found it was critically important for residents to have a single accessible point person to contact when there was a need. This alleviated a tremendous amount of anxiety and stress. A participant did not have to navigate the healthcare system and could have their needs immediately met. This factor alone showed a significant reduction in office visits and reduction of healthcare dollars.

All of the participants had positive reviews of their involvement in the program. Many of them commented that they felt like they were ‘special’ and that it dramatically reduced their anxiety when dealing with health issues and navigation of the system. Unanimously, they would highly recommend the program to others.

About the Los Angeles Jewish Home
Founded in 1912, the non-profit Los Angeles Jewish Home (LAJH) is among the largest providers of senior healthcare services in Los Angeles. Through its innovative Connections to Care ® program, each year thousands of seniors benefit from the Home’s community-based and in-residence programs. Community-based programs include: A Program of All-inclusive Care for the Elderly (PACE); hospice; home health; palliative medicine; community clinics; short-term rehabilitation; and acute psychiatric care. Three Home campuses serve seniors with options for independent living, residential care, skilled nursing care, short-term rehabilitation, and Alzheimer’s disease and dementia care. A fourth campus holds the Annenberg School of Nursing (ASN), offering comprehensive vocational nurse, nurse assistant, and home health aide programs. The Home has two Continuing Care Retirement Communities (CCRC), the Gonda Healthy Aging Westside Campus, in Playa Vista, CA and Fountainview at Eisenberg Village in Reseda, CA. . Further information regarding the Jewish Home can be found online at http://www.lajh.org or by calling 855.227.3745.

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Bonnie Polishuk
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