Faced with a "Medicare access crunch" of elderly patients and a lack of doctors to treat them, one North Texas health system is testing a unique approach to bolster access.
Last week, Texas Health Resources began rolling out its new line of clinics specially tailored to those patients 65 and older in its service area. With most primary care docs having packed schedules, Medicare beneficiaries have struggled to find open slots, sometimes ending up in the emergency department.
To address that gap in care, THR is opening three "Your Health Center" clinics, custom-made specifically for seniors, says Dan Varga, M.D., chief clinical officer and senior executive vice president. Clinics include everything from hallways with handrails to larger exam rooms that accommodate wheelchairs and walkers, handicap-accessible scales, and large-print forms for easier reading. The Arlington-based, 24-hospital system will alleviate the doc strain in its market by using nurse practitioners to staff the three clinics, each led by a physician medical director.
Based on consumer data and feedback the system has gathered so far, Varga has little uncertainty about the clinics' future success.
"We don't have any doubts that these clinics are going to be sitting around waiting for folks to show up," he says. "The demand is enormous for this right now. I know that seems really strange, relative to other areas in the country where Medicare, particularly in the primary care world, tends to be the bread and butter of a practice."
The first location just opened last week on Texas Health's campus in Burleson, a suburb of Fort Worth, with another to follow next month in the city of Plano. A third will follow in Arlington later this year, with a slant more toward the surrounding Latino population, including bilingual staffers and Spanish-language handouts. Varga says they picked these locations based on demand data in the areas — with large populations of underserved Medicare recipients and proximity to other health system facilities, in case a patient needs further care.
In addition to the amenities, Texas Health will also build out the staff for each Your Health Center with the Medicare population in mind. Those on the roster include physician assistants, dietitcians, social workers and case managers to shepherd patients with multiple chronic conditions through the system.
Varga thinks this model would make sense elsewhere, regardless of your hospital's level of doc shortage. It's physician-centered, but not physician-reliant, and allows patients lengthier opportunities to consult with a clinician, and clinicians more of a chance to know their customers' medical histories. Plus, it's timelier and cheaper for both the patient and the hospital. Texas Health Resources is making a systemwide push to ensure that all lower-level practitioners are working to the top of their licenses, and he believes other health care organizations across the industry should be doing the same.
"The Medicare access crunch here in the [Dallas-Fort Worth] metroplex was the driver to create this model, but across the country, everybody is migrating toward this. North Texas just hasn't had a reason to do it," he says. "Doctors had more than enough patients to see and most of them were commercial, so the economics of private practice were pretty good. That's not necessarily the case in other markets across the country. But, at the end of the day, a top-of-competency, multidisciplinary primary care access model, we think, is a better model, whatever the economic implications are in your market."
For more on trends in treating senior patients, be sure to check out our Boomer Challenge series from last year that examines the many ways the nation's 75 million baby boomers will impact the U.S. health care system as they age into retirement and senior citizenhood.