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Care model strives for efficiency

Heather Del Villar used to care for older patients who were repeatedly admitted to the hospital for complications of congestive heart failure and diabetes.

Now, she works in a Modesto care center that manages chronic disease for Medicare patients, so they are healthier and stay out of hospitals.

It's a novel approach that changes the way care is delivered and reduces costly hospital stays that tax the federal Medicare system, which is for people 65 and older and disabled adults.

"These patients keep going back to the hospital because their disease is not under control," said Del Villar, a nurse practitioner at the CareMore Health Plan center on McHenry Avenue. "We prevent their conditions from getting worse. It makes sense from the patient's standpoint, the medical standpoint and the business standpoint."

Del Villar works for the CareMore Health Plan, one of the few companies that hired last year as the county jobless rate climbed toward 20 percent. In a modest gain, CareMore put 22 people to work, including medical assistants, case workers, an office manager, physician, sales staff and exercise program trainers. All but a few were hired locally.

Del Villar worked in Southern California hospitals before joining CareMore in 2008. As of October, the Medicare health plan had 35,000 subscribers in California, Nevada and Arizona.

Since receiving government approval last year to enroll seniors in Stanislaus County, the plan has signed up more than 1,500 subscribers here.

Del Villar moved to Modesto when CareMore opened the McHenry Avenue center in December. The center is an example of changes coming to conventional patient care as the health industry tries to become more efficient.

Del Villar manages patients with diabetes, hypertension and kidney ailments, as well as providing wound care and treating other symptoms of the chronic diseases.

By using high-tech equipment at the center, the staff daily monitors 80 patients in their homes.

Monitoring checks for signs of trouble

Every morning, 72-year-old Margaret Gray of Ceres puts on a device that measures her blood pressure and heart rate. The data is sent from her home to the center over a telephone line, and the staff takes action if her blood pressure is high.

The equipment also remotely monitors the weight of people with congestive heart failure. If a patient at home gains three pounds overnight, it's a sign of fluid retention and the patient is summoned to the office for treatment with medication, Del Villar said.

Without the monitoring, a patient retaining fluid in the legs soon would be back in the hospital.

CareMore recruited a physician from outside California to see patients who need to be put in the hospital or a convalescent facility.

The health plan says its chronic disease management has reduced hospitalizations within its system by 50 percent.

While the CareMore system created some jobs for Stanislaus County, the approach won't likely generate net employment because it strives to make health care more efficient. But Del Villar said she jumped at the chance to help bring the system to Modesto.

"It is a really unique model," Del Villar said. "When I was looking for a job, I knew it was the right fit."

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.

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