The Department of Health and Human Services released a report on Oct. 24 that indicates 2017 premiums for mid-level plans under the Affordable Care Act will increase by 25 percent, with some states seeing larger increases.
Now is a good time to evaluate health care providers, and with so many options available, it’s important to understand the services and benefits provided for each.
For people 65 and older, and for younger people who qualify, open enrollment for Medicare has been underway since Oct. 15 and will end Dec. 7.
HealthCare Partners can get you started at http://tinyurl.com/hcpopenenrollment.
What is HealthCare Partners?
For decades, health care in the United States has been fragmented, and it’s no different in Los Angeles County. “Scores of hospitals and numerous physician practices are scattered across a vast and congested area that is home to 10 million people,” according to the January 2013 issue of the California Health Care Almanac. “Hospital systems and physician organizations tend to operate in isolated silos without an intensive footprint across the county.”
The fragmented health care market, however, is coalescing with the help of organizations like HealthCare Partners.
HealthCare Partners is a medical group that has a network of over 65 medical offices that employ directly or contract with 2,200 primary care physicians and over 4,000 nurses, specialists, and health educators. It is one of the highest rated medical groups in California as well as one of the largest single providers of pre-paid health care for seniors in the state.
Its service areas include San Gabriel Valley, Pasadena, Orange County, Los Angeles, South Bay, Long Beach, as well as San Fernando and Santa Clarita Valleys.
“What’s special about HealthCare Partners with regard to insurance is that we have contracts will all major insurance companies,” says Patricio Camacho, marketing manager at HealthCare Partners. “We accept 12 insurance companies on the Medicare side and a larger number of insurance companies on the commercial side.”
All insurance companies are striving to have a high rating and working with HealthCare Partners helps them, according to Camacho. Most insurance companies strive to be like Kaiser, which has been rated 5 Stars by the Centers for Medicare and Medicaid Service, a government agency.
“We compete with Kaiser, but we offer more options,” says Camacho. “They have Kaiser Insurance, Kaiser Medical Group, and Kaiser Hospital. So, when you enroll in Kaiser, you have to use a hospital, doctor and specialists from Kaiser. With HealthCare Partners, you can get your insurance from various companies. So you have more options. And you can go to a variety of hospitals.”
There are over 400 hospitals in California, and some of the top ranked ones, according to the US News and World Report, are within the network of HealthCare Partners.
“We have contracts with some of the best hospitals in the area,” Camacho says.
For those living in San Gabriel Valley, HealthCare Partners includes physicians from Arcadia, Temple City, Pasadena and San Gabriel.
Patients can go to Huntington Memorial (Ranked 9th in California), Methodist, Citrus Valley Medical Center – Queen of the Valley and Inter Community, USC Verdugo Hills, Foothill Presbyterian, or San Dimas Community.
There are nearly 40 affiliated hospitals in the Greater Los Angeles area, including Glendale Adventist (Ranked 24 in California), Long Beach Memorial Center (Ranked 21), Torrance Memorial Medical Center (Ranked 21), St. Joseph (Ranked 17) and Orange Coast Memorial Medical Center (Ranked 29) in Orange County; Providence St. Joseph Medical Center in Burbank (Ranked 48), and Providence Tarzana Medical Center (Ranked 37).
Communication between Primary Care Physicians and Specialists
One of the main benefits of using HealthCare Partners is its “Coordinated Care Model,” or communication between physicians and specialists on behalf of their patients.
For example, if a primary care physician suggests that their patient see a gastrointestinal specialist to look at the cause of stomach pain or acid reflux, the physician and specialist communicate directly so that details about the patient such as what medicine he or she is taking or has taken in the past is clearly understood.
When primary care physicians and specialists don’t communicate, there’s a risk that crucial details about a patient’s health will be left out.
The medical journal JAMA Internal Medicine, which is published by the American Medical Association, published an article highlighting the need for improved communication between primary care physicians (PCPs) and specialists.
Research indicated that 69 percent of PCPs reported they “always” or “most of the time” send specialists notification of their patients’ history and reason for consultation. Further, only 35 percent of specialists reported receiving those notifications.
Conversely, 80 percent of specialists reported they “always” or “most of the time” send PCPs consultation results to the referring PCP, and 62 percent of PCPs reported that they receiving those notifications.
“When providers work together to coordinate a patient’s care, the result can be happier, healthier patients, faster recovery by those who are ill or hospitalized, and improved quality of life for those with serious and chronic conditions,” HealthCare Partners’ website states.
The medical group claims it’s able to keep costs low through efficiencies like better coordinated care as well as through customizing patients’ treatment.
“The secret of HealthCare Partners is that we are able to well categorize patients according to what they need,” says Camacho. Some patients can’t take care of themselves, some have chronic conditions like high blood pressure, arthritis, and diabetes; and some patients can’t leave their homes, he says.
To address patients’ needs, HealthCare Partners offer the following types of services:
– Self-Management and Health Education Programs for patients with chronic disease
– Complex Care and Disease Management for patients with diabetes, COPD, CHF, CKD, depression, dementia, cancer, or who need an organ transplant
– High Risk Clinics and Care Management for more intensive one-on-one physician/nurse-patient care
– Home Care Management for frail and homebound patients
In addition to its Coordinated Care Model, HealthCare Partners prides itself in it’s aftercare services, which it says is a factor that distinguishes it from other health care agencies.
“We address all the medical conditions on time,” says Camacho. “When a person comes to HealthCare Partners, we try to get the patient seen and evaluated immediately so that we know the medical conditions of patients immediately.
“We make sure that the patient has his or her medications; we make sure the patient is referred to the appropriate specialist. A lot of the times when patients are released from hospitals, they get forgotten by their medical group. In the case of HealthCare Partners, we have a department responsible for coordinating aftercare services,” says Camacho.
The aftercare service coordinates transportation for patients as well as if they need a nurse, medical equipment, a pharmacy, or even meals.
“We are coordinating with the patient all the time to make sure the patient is healthy,” says Camacho. We don’t leave room for mistakes that will cause suffering to patients.”