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AtlantiCare Offers Special Care Center to Help Patients with Chronic, Costly Conditions

6-23-14

By Lauren Wanko
Correspondent

Atlantic City Resident Keith Watkins doesn’t visit the ER as much anymore since he joined AtlantiCare’s Special Care Center.

“It’s better for the insurance and it’s better for me too,” Watkins said.

“We take care of the chronic, costly and complex population,” said AtlantiCare Senior Vice President Steven Blumberg.

The Special Care Center, which serves 1,600 participants, launched in 2007 by a number of partners including an Atlantic City casino union. It was created in response to rising health care costs and the desire to help chronically ill patients who typically account for the bulk of those costs.

A team approach helps the Care Center achieve that goal. They meet every morning to discuss the details of their patients, all of whom are assigned a health coach.

“Coach is a guide or an advocate to make sure they have access to the services they need. At end of day, prevent downstream, more intense and more complex and ultimately more costly interventions,” Blumberg said.

The program has resulted in a 50 percent reduction in preventable emergency room visits, according to Special Care Center data. And hospital admissions and re-admissions have also decreased.

Here at the Special Care Center, chronically ill patients typically meet with their physician six to eight times a year and visit with their health coach 35 to 40 times a year to treat health issues like diabetes, congestive heart failure, COPD and asthma.

“They do see us more often. We not only take their vitals, which they’re so used to it, but we engage them and tell them what their goal has to be,” said Health Coach Milagros Laya.

“I credit here with keeping my alive today. I don’t know where I’d be without here today,” said patient Norman Saunders.

The patient’s employer or insurer pays the Special Care Center, which is located in two locations in Atlantic County, a flat fee per month instead of paying for visits. Most co-pays are waived for visits and medications. The pharmacy and lab are onsite too. Patients can reach a doctor on the phone at any time.

“If we can and get them access to this low intensity setting and we can get them the maintenance medications they need to stay healthy, we’ll save substantial dollars downstream,” Blumberg said.

“We treat the patient as a whole. You know it’s not like we treat diabetes, we treat the patient with diabetes,” said Special Care Center Medical Director Dr. Ines Digenio.

“The name is Special Care. Really it means it’s special here,” said patient CRA Siddiqui.

AtlantiCare recently created similar programs for uninsured patients and continues to roll out many of the care center’s concepts in their primary care practices.