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A recently admitted patient experiences complications from surgery and requires IV medications, or at worst, a blood transfusion.
But rather than consulting with the patient’s physician to arrange for rehospitalization, the physician returns your call within 15 minutes and arranges to complete the needed care in the patient’s room. Sound unlikely? Actually, the scenario is not so far-fetched and could become more common, says Kim Phan, MBA, vice president of operations at GeriNet Health Services. GeriNet Health Services is the management arm of GeriNet Medical Group, a specialty physician practice group based in Costa Mesa, CA.
GeriNet’s primary customers are managed care organizations (MCOs), but patients not enrolled in Medicare managed care plans can still obtain services. "We have about 75% of our patients enrolled in Medicare managed care plans. From a total population of 45,000 covered lives, we are caring for about 1,000 in post-acute settings at any given time," says Phan.
GeriNet’s expertise at caring for subacute care patients comes from the staff’s involvement in a staff-model health maintenance organization (HMO). When the HMO began divesting, the physicians formed a group practice last April and started recruiting managed care contracts on their own, notes Phan.
Staff for the medical group include four physicians, three nurse practitioners, one part-time physician assistant, and eight subcontracted physicians. Specialty care provided includes the following types of post-acute services:
• wound care;
• orthopedic care;
GeriNet’s staff provide care in long-term care facilities and transitional care units in health care facilities throughout southern California. But aside from the clerical and administrative functions performed in the Costa Mesa office, the physicians and nurse practitioners have virtual offices. The staff is divided into three medical teams that cover geographic regions. Physicians access medical information via laptop computers or PCs at their homes. "The physician can order tests or labs directly from home," adds Phan.
To help them get started, GeriNet hired a management information system (MIS) consulting team to assist in creating a customized information system. "We track things the MCO would like, such as diagnosis, admissions, where the patient is now in the continuum, labs, tests, and consults ordered," notes Phan.
Serving as an extension to the MCO’s primary care physician is the group’s best marketing strategy, notes Phan. "We show the MCO how it is better to have us going on rounds in the nursing home and transitional care unit and let the primary care physician stay in their office. It’s being proactive rather than reactive," adds Phan.