Sept. 16Wake Forest Baptist Medical Center has turned to a familiar health care provider as part of its attempt to improve post-hospital care and reduce readmissions for older patients.
The center has formed a joint venture with Gentiva Health Services, known as Wake Forest Baptist Health Care at Home. Dr. Franklin Watkins, an internist and geriatrician at the center, will serve as medical director for the joint venture.
In July 2007, Gentiva bought N.C. Baptist Hospital's home-health program for $3.8 million, which served about 1,500 patients a year at that time. That program was called Baptist Hospital Home Care.
Gentiva has more than 400 offices nationwide, with 33 in North Carolina. In the Triad and Northwest N.C., Gentiva has three locations in Winston-Salem and one each in Asheboro, Greensboro, Kernersville, King and North Wilkesboro.
Since the sale, Wake Forest Baptist "has reinvested in home health," said Pamela Duncan, director of transitional outcomes at Wake Forest Baptist.
Wake Forest Baptist officials said the joint venture will offer more options for post-hospital care for the elderly, as well as assist adult patients with complex health problems in returning to their home.
"Services are designed to help clinical teams and home health providers coordinate their activity and standardize treatment protocols," Duncan said.
"We believe this will allow for more effective interactions with patients and their families/caregivers, improved patient outcomes, as well as better patient and family experiences."
Wake Forest Baptist said it is bringing to the joint venture 25 years of evidence-based research from its Sticht Center on Aging and Rehabilitation. Among its participants in the joint venture will be geriatricians, neurologists, internists, nurse practitioners, pharmacists and therapists.
"We have really brought academic medicine and industry together to marshal the strengths of each entity's integrated care," Duncan said.
David Causby, president of Gentiva's home health division, said in a statement the joint venture "marks a unique chance to create a true partnership with a leading organization ... and prove the value of our national care transitions efforts."
Dr. Jeff Williamson, clinical director of the Sticht Center, said the joint venture stands out because of "the integration of physician leadership to provide continuity in overseeing each patient's journey from the hospital to their home until their primary care team can resume care."
In August, N.C. Baptist Hospital learned it would receive for the second consecutive year the largest Medicare reimbursement penalty among the state's urban hospitals for how many of its patients are readmitted within 30 days of discharge.
The penalty rose from 0.72 percent of payments to 0.73 percent. The maximum penalty is 2 percent. The cost to Baptist was estimated to range from $730,000 to $980,000 in the federal fiscal year 2012-13.
For the second consecutive year, Forsyth Medical Center and Moses Cone Hospital will not be hit with a reimbursement penalty.
The Centers of Medicare and Medicaid Services focuses on three categories heart attack, heart failure and pneumonia in its attempt to reduce hospital readmission rates for Medicare patients. Hip and knee surgery and chronic obstructive pulmonary disease are being added in fiscal 2014-15.
The Affordable Care Act authorizes Medicare to reduce payments to acute-care hospitals with excess readmissions.
Wake Forest Baptist expected a slight increase "because the impact of our readmission reduction initiatives has not been fully realized," Duncan said in August. "Wake Forest Baptist is partnering with other hospitals, nursing homes, home health, hospice and palliative care to help bridge gaps and improve patient care and medical outcomes."
For example, Forsyth and Wake Forest Baptist have formed a partnership aimed at enlisting local nonprofit organizations to help reduce readmission rates by at least 20 percent. An estimated 3,000 Medicare patients in Forsyth and the surrounding areas could be affected by the initiative.
"But it takes time for this to work," Duncan said in August. "It will likely be 2015 or 2016 for the full effect of our collaborations to be felt in our community and appear in the CMS reports."
(c)2013 Winston-Salem Journal (Winston Salem, N.C.)
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