One space, complete care
The new VCU Center for Advanced Health Management is bucking national trends by changing the way debilitated, chronically ill patients receive health care.
Centrally located in Richmond, Virginia’s, Northside, the center provides a fresh take on care by providing physicians, pharmacists, laboratory and radiology services as well as psychologists and social workers all from a single and fully accessible location.
Designed and directed by Peter Boling, M.D., professor and chair of the Division of Geriatric Medicine in the Department of Internal Medicine, the center aims to reverse the trend of high-cost, low-quality care by repairing what he describes as “a broken system” for debilitated, chronically ill patients.
“Chronically ill individuals — not just at VCU, but nationwide — have great difficulty accessing the system until their conditions become urgent,” said Boling, adding that care is often spread out across numerous doctors, hospitals and other care settings, while billing spans multiple payers such as Medicare and Medicaid for patients who are eligible for both. The end result, he said, too often includes poorer quality of care at substantial yet avoidable costs.
Nationally, chronically ill patients make up 20 percent of health care rosters but account for about 80 percent of expenses. A VCU Medical Center study revealed that just 5 percent of patients accounted for a whopping 64 percent of its health care-related expenses in 2012.
Numbers like those are what led to the creation of the center at VCU, which replaces traditional health care models with a system that not only increases accessibility to services but also reduces both the average length of inpatient services and patient readmissions.
Beyond its physical borders, the center’s staff offers home-based care, nursing home services and consultative inpatient care coordination, while telemedicine services (including home monitoring with triage and video consultations) answer the need for 24/7 attention and care.
Hope Witcher said the program has been a godsend for her daughter, Zekeyah, who has cerebral palsy. It’s the family’s first time having access to home visits and coordinated care, which eliminates travel and decreases taking time off from work for appointments.
“Now that we’re with the center, I just keep asking myself, ‘Where has this been all of our lives?’” Witcher said. “I look at Zekeyah and she’s smiling. She’s always been a happy individual, but now you can see that she’s just healthier, every day.”
Boling’s team has practiced that type of care for years, said John D. Ward, M.D., president of MCV Physicians. He pointed to VCU’s House Calls program, which cares for elderly patients in their homes when they’re simply too sick to visit their primary care doctors and would otherwise end up at the hospital for emergency care.
The center’s ability to provide timely, effective, personal and highly coordinated care places VCU Medical Center on an exemplary pedestal as the number of people with complex, chronic illnesses rises nationwide along with demands for better and less expensive health care.
It also was a factor that led to an invitation in 2014 to join just four universities nationwide in the University Healthcare Consortium’s Chronic Disease Medical Home pilot program, which examines the impact of comprehensive facilities and team-based systems like VCU’s Center for Advanced Health Management.
“Data proves that this system and facility provide the best possible care, while also reducing hospitalizations and ER visits, which reduces costs,” said Ward. “Going forward, I think that you’re going to see all sorts of team-based models arriving in all specialties, right down to family medicine.”