This new care model has stitch-in-time approach

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James M. Berklan, McKnight's Editor
James M. Berklan, McKnight's Editor

Every enterprise needs worker bees. Clearly, if the work is going to get done, those on the frontline — and elsewhere — must soldier on.

But if an enterprise — be it a company, industry or other entity — is going to survive into the future, it also needs a visionary. Without forward-looking inspiration, any enterprise will surely fade, just as a houseplant will shrivel without mindful tending.

That's why it's always so interesting to hear the latest from Jeff Petty. The CEO of Wesley Enhanced Living in Pennsylvania, Petty is dissatisfied with the status quo. They key is he's not just part of a hand-wringing crowd; he's pushing new plans he's helped devise.

In mid-July, U.S. Rep. Mike Fitzpatrick (R-PA) introduced the Medicare Residential Care Coordination Act of 2013, a piece of legislation with Petty's fingerprints on it. The bill would create a demonstration project that would test a new model of care, one that would offer seniors lifetime health and housing benefits within existing Medicaid and Medicare programs.

The program would offer more efficient care coordination services than most seniors could do on their own. The power of H.R. 2376 is the way it would eliminate duplication and inefficiency in service offerings, Petty says. He's talking about 25% Medicare and 20% Medicaid savings, plus improved health outcomes. On-site care coordination and disease management would help avert hospitalizations.

“It becomes a model that ensures lifetime housing, healthcare and security,” Petty told me. “It's completely replicable and scalable, nationally.”

The key, he said, is to avoid not the rehospitalization but the first hospitalization, and also delay the onset of chronic conditions.

“Savings aren't where we're managing the chronic conditions better,” he explains. “The ‘home runs' are going to come in the things you can do to avoid hospitalization in the first place.”

A change in thinking — and what is pursued — is needed.

“You can't continue to do things the same way and expect a better result, both in terms of quality and cost,” Petty says. “The hardest thing for us as a field is to recognize we have to step into the new generation. We have to find the next idea.”

Whether it's Petty's idea that brings a solution might be moot. The bigger point is he's in there swinging, trying to put a visionary's stamp onto a better future for all providers.

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