Summer Fall 2017

20 » A magazine for and about Oregon Community Hospitals. Developing Transitional Post-Acute Care in Rural Hospitals Rural residents in Oregon and other communities across America have access to fewer healthcare services, lower insurance coverage rates, fewer physicians per capita, and higher chronic disease rates than their urban peers. In rural communi- ties, 20 percent of Medicare-aged patients are hospitalized each year and a signif- icant number require care after being discharged from the hospital to assist them in their recovery from serious illnesses. Some are hospitalized in larger facilities far from home. But in a new program, they can now receive their follow up recovery care in their home communities at their local critical access hospital. Allevant, developed by Mayo Clinic and Select Medical, has collaborated with OAHHS to establish Transitional Post-Acute Care programs in critical access hospi- tal member facilities. The three-year program began January, 2017 and 18 Oregon critical access hospitals are participating. To date over 1,000 Oregon critical access hospital staff members have started the training and education. Hospital-based transitional care programs offer a number of important advantages such as an excellent-to-patient ratio, strong team cul- ture, the ability to address sudden changes in condition with on-site physicians, radiology, and laboratory, and most importantly, a patient- centered approach that includes bedside rounds with the care team on a regular schedule. Hospital-based transitional care is the ideal set- ting for patients with complex health conditions and post-acute needs. By offering these services in rural hospitals, patients, and families can get high quality post-acute care close to home “Even though we are only a few months into the collaboration, it is really great to be able to see how Oregon’s rural care teams are so willing to share strategies with each other on this effort. It’s not a competition…it’s about the best for every patient,” said Karl Palmer, RN, Director of Clinical Services for Allevant Solutions. deductible plans or are under-insured. Having the virtual option, which costs $39 per visit, helps keep care accessible and affordable. It also allows CMH to keep up with the latest developments in health care technology. Grand Ronde launched their VCS last fall, making the service available first to employees and their family members, who are able to tap into it for just $10 per visit. They can also use the service in states where other hospitals offer it, too. Good Shepherd expanded the offering to the general community in January of this year. Visits for community members cost $35. “It’s been a great service,” Romer said, “and as far as the launch process—in all my years of starting new programs, this was the smoothest. Carena really does a nice job.” One of the biggest challenges with VCS has been figuring out a way to have the service accommodate the Medicaid popula- tion. Schlenker, Romer and McPherson all said that’s not yet been an option, but it’s one they’d like to see. “Unfortunately, federal regulations prohibit us from provid- ing virtual care to patients with Medicaid or Tricare insur- ance,” McPherson said. Until that issue gets worked out, the hospitals using VSC VCS said they plan to continue offering the service and expanding it as much as possible. All have various marketing and educa- tion campaigns to help spread the word, and the more people use it, the more people will learn about it. In addition, as tech- nology like smartphones and social media continues to become even more commonplace, especially with older patients, the virtual model is likely to catch on in a bigger way. “I’d say the younger you are, the more you use technology like this, but that’s going to change,” Schlenker said. “I never thought my mom would be texting me, but she does it all the time now. And for this purpose, more and more people are just going to realize how easy it is to do.”  H continued 

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