Dr. Richard Afable
St. Joseph Hoag Health
There are many important reasons why St. Joseph Hoag Health is transitioning to add ambulatory care sites and include mobile health methods, in addition to our acute-care hospitals. The need for greater access under healthcare reform and the Affordable Care Act is just one of the reasons.
In fact, the need to make healthcare and preventive programs more convenient for those we serve is something we identified several years ago, long before the ACA became law. This strategy was born from a system commitment to improve the health of our communities, a strategy that reflects our mission and values as a nonprofit, faith-based and community-focused health system.
For several years now, we have made a substantial investment in ambulatory care, with integrated health centers throughout Orange County for convenient access to expert care.
We have also established an extensive network of urgent care centers throughout the greater Orange County area for treatment of nonlife-threatening emergencies.
All of these are in addition to the wide network of medical groups and affiliated networks available through St. Joseph and Hoag Heritage medical groups.
Newly created relationships and partnerships with employers in Orange County provide more impetus to further develop outpatient and ambulatory services. We are exploring innovative programs, such as our St. Joseph Hoag Health Wellness Corners, putting medical and wellness sites right where people work and live.
The goal is to become a part of people’s daily lives, helping them maintain a healthier lifestyle and managing chronic medical conditions outside the acute care setting when appropriate. St. Joseph Hoag Health now offers both residential and worksite versions of our Wellness Corners. The response from employers, employees and residential communities has been very positive.
We also cannot forget the importance of reaching people through the digital space, through patient portals, health “apps” and other news means to conduct tele- and mobile health. We want to be the trusted partner where and when people look for health care in Orange County and beyond.
MemorialCare Health System
Well before reform, MemorialCare Health System was working to ensure we were strongly positioned for the nationwide move from traditional models of care concentrating primarily on hospitals to truly integrated care.
Our ongoing strategic efforts focus on expanding MemorialCare to cover all aspects of the care continuum, from wellness and prevention to diagnosis, treatment and rehabilitation—keeping people healthy and caring for them when they’re not in the most effective setting—much of which is outpatient care.
The tidal change in healthcare delivery and changing needs of consumers and employers have driven and inspired our vision for growth, diversification and partnerships.
The past was characterized as hospitals and providers caring very well for people when they were sick or injured, mostly in the hospital. Today we focus on prevention to keep people healthy, and more directly with employers, all driving our extensive expansion into community-based sites of care. By moving to outpatient settings, we are providing value and convenience for patients and their families, as well as employers, payers and other stakeholders.
Of our more than 200 care sites, six are hospitals. The rest are outpatient facilities, including ambulatory surgery centers, imaging centers and urgent-care centers, physician practices, and other programs and services that supplement inpatient hospitals, operating rooms, imaging departments and emergency and trauma centers. Lower-cost outpatient centers shift services into our less-expensive outpatient environments conveniently located from the South Bay through South Orange County.
Additionally, technology allows more patients to be cared for in outpatient settings. Many surgical patients, for example, who used to spend two to five days in a hospital, are referred to outpatient surgery centers, receiving safe, high-quality care without overnight hospital stays, thanks to advancements in minimally invasive, laparoscopic technologies and other techniques.
MemorialCare supports and embraces this trend. We believe funding high-quality, lower-cost healthcare services in outpatient centers is absolutely essential. If you can be safely cared for in ambulatory surgery, imaging or urgent care centers at much lower prices than a hospital, then that may be the best location. And it is likely that your health plan will insist upon it.
We will continue seeking opportunities to grow our outpatient centers and primary care locations to provide access, convenience, and affordability for our patients and to develop innovative partnerships with other hospitals, health systems, employers, brokers, payers and others—both within and outside the healthcare arena.
Los Alamitos Medical Center
Los Alamitos Medical Center, working with our parent company, Tenet Healthcare, quickly developed and implemented innovative strategies that anticipated the passage of the Affordable Care Act. For example, our Path to Health initiative enabled us to educate our community about the new health insurance options available under the act and help formerly uninsured individuals choose the right physician and health plan for their healthcare needs. We partnered with various organizations in the community to support this outreach campaign, which seeks to simplify the complexities of the law and provide user-friendly guidance and tips on what individuals need to know in order to make sure they are ready for the open enrollment period and beyond.
Since the inception of the act, Los Alamitos Medical Center has seen a steady increase in the number of patients enrolled in the state insurance exchange utilizing our inpatient and outpatient services. We expect additional growth and increased utilization of these services this year.
Our outpatient strategy to improve access and convenience for our community started several years ago with the development of the Total Care Outpatient Pavilion, which houses some of our most highly utilized outpatient services for cancer care, infusion and imaging in a separate building on the hospital campus. Within the main hospital, our new integrated-imaging and interventional neuroscience and cardiovascular biplane lab has expanded and enhanced our outpatient oncology and cardiology services. A second interventional lab that will allow us to perform electrophysiology studies will be opening this summer.
Understanding that healthcare is a local business, we have also invested in community-based outpatient imaging centers, surgical centers and urgent care centers, all with the intent of providing excellent healthcare close to our residents’ homes.
Our community-based outpatient centers include Reagan Ambulatory Surgery Center in Los Alamitos and Walker Street Imaging Center and MedPost Urgent Care, both in Cypress. With Tenet, we plan to open additional urgent care centers in the area. These outpatient centers are geographically well-positioned to meet the needs of patients requiring treatment.
The Affordable Care Act incorporated many principles that Kaiser Permanente has advocated for more than 70 years, including the new concept of integrated medicine.
Integrated medicine, pioneered by Kaiser Permanente, is now widely accepted as the model in American healthcare, advocating and following a holistic approach to patient treatments and outcomes. At Kaiser, all facets of care, from outpatient to inpatient and even long-term care, are interconnected.
It’s called Total Health, improving the physical, mental and social well-being of all our members.
The success of this integrated philosophy of healthcare delivery has tangible and even dramatic results. We have reduced the rate of serious heart attacks by 36% and greatly reduced the number of advanced-stage colon cancers through earlier detection by coordinated screenings in our outpatient clinics.
The key to such results is the preventive benefits of integrated medicine, being proactive in our outpatient encounters, and the belief that improvements can always be made, finding new ways to meet our patients’ needs.