Thanks to a new program with ApolloMed, a medical management services company, Anthem Blue Cross begins offering hospitalist services to its Medi-Cal members in Los Angeles County, California this month.
Anthem plans to leverage ApolloMed’s existing presence in 24 acute care hospitals in the area and to reduce costs by more efficiently managing members’ in-hospital care. The program serves adult Medi-Cal members only. This includes members who are enrolled in California’s Seniors and People With Disabilities (SPD) program, if they have selected Anthem after the shift to managed care this month.
Anthem’s state sponsored business president, Kevin Hayden, said that the agreement with ApolloMed is designed to enhance the quality of care that members receive during hospitalization, which would help improve outcomes.
Anthem members who participate in the program will see a physician several times each day during their hospital stays, which will help docs keep a close eye on their patients’ progress, as well as planning more timely discharges. Transition plans will include outpatient follow-up care as well as support services in an effort to prevent unnecessary readmission.
Hayden said that hospitalization can be upsetting for Anthem members, and that the insurer created the program to be sure that Anthem members have access to comprehensive healthcare and feel confident they will have a successful discharge and recovery period.
President and chairman of Apollo Medical Holdings, Adrian Vazquez, MD, said that ApolloMed’s objective is to “manage members hospitalizations and collaboratively plan for an effective transition to an outpatient setting.”
Considering the current state of healthcare reform and the consistent efforts being made to reduce hospital readmissions, the industry is likely to see the role of hospitalists expanding in the inpatient setting in coming months and years.
Research published by the Journal of the American Medical Association found that when hospitals focus on inpatient management, hospital stays can be reduced by as much as 30 percent—and the associated costs can be reduced as much as 20 percent.
The new hospitalist agreement complements existing Anthem programs that are available to Medi-Cal members, including programs like the DailyMed Pharmacy Program, 24 hour care management and Anthem’s 24 hour physician on call program.
Representatives of ApolloMed said that the medical management services company intends to add more hospitals in the region as well as additional post-discharge outpatient clinics. The idea is to make sure that members have easy access to follow-up care from until their own medical providers are ready to continue managing their care.
By Angela Atkinson
Judd Matsunaga of Elder Law Services is a qualified attorney who has helped hundreds of California residents with Medi-Cal Planning. Mr. Matsunaga can be reached for a free consultation by calling 1-800 403-6078.