Hospitals in pursuit of excellence

AtlantiCare Special Care Center

AtlantiCare
Atlantic City, NJ
538 Beds

The Problem
The Special Care Center is a primary care center established in conjunction with large area employers that serves slightly over 1,000 patients. This care coordination program is specially designed for patients facing a chronic illness such as heart disease, diabetes, hypertension, obesity, asthma or emphysema.

The Solution
The Special Care Center puts the patient and his or her family first in the physical, medical and social design of the clinic. The following practices have improved patient compliance and satisfaction: (1) All patients are assigned a non-clinical health coach to help them proactively manage their care and navigate the health system. Health coaches make contact with each of their patients at least once every two weeks; (2) New patients receive a one-hour appointment with a physician and existing patients receive 30-minute physician appointments; (3) The complete interdisciplinary care team shares 24-hour call coverage so that patients can contact them at any time with health problems. Data capabilities allow them to pull up patient charts from home and refer to the Emergency Department if necessary; (4) All patients are guaranteed same-day sick visits; (5) Patients have access to group education on a variety of issues, which are segmented out by type of condition and provided in several languages; (6) All patients who make a sick-visit will receive a follow-up call from their health coach within 24 hours of leaving the office; (7) Patients have no co-payments for physician visits or prescriptions filled at the on-site pharmacy, which both encourages patients to get their prescriptions there and allows the care team to monitor adherence.

The Result
Initial results have displayed improved clinical incomes and significantly lowered treatment costs. According to analysis conducted between 2008 and 2009, patients experienced 41% fewer inpatient admission, 48% fewer Emergency Department visits, 25% fewer surgical procedures and improved outcomes in pharmaceutical adherence, quality indicators and generic use. Spending on primary care visits, prescription drugs, labs and testing all increased. It is assumed that these increases are a result of increased compliance. The program still produced a first-year savings of up to 28% off of net total spending for the highest risk quarter of patients.

This case study was originally featured in the HPOE guide: "Caring for Vulnerable Populations," published January, 2012.