Senior living resident access to physician services is often limited by transportation availability. As such, senior living organizations can increase their ability to recognize warning signs and avoid transfers to the hospital with on-site physician services. In fact, the Florida Medicaid program found that nearly one-fourth of the hospitalizations for its assisted living beneficiaries were preventable simply with greater access to outpatient services, including primary care delivered by a physician or advanced practice nurse.

Partnership remedies PCP management challenges

Source: Bynum, Julie P.W. et al., “Fewer Hospitalizations Result When Primary Care Is Highly Integrated into a Continuing Care Retirement Community,” Health Affairs, May 2011; Kendal at Hanover; Post-Acute Care Collaborative interviews and analysis.

To remedy this issue, Kendal at Hanover, a continuing care retirement community (CCRC) in New Hampshire, partnered with Dartmouth-Hitchcock Medical Center to build an on-campus clinic at the CCRC. In this case, a care team at Dartmouth Hitchcock staffs the clinic at Kendal and utilizes read-only access to the health system’s electronic medical record.

Dartmouth clinicians take 24/7 call coverage for the CCRC residents and even facilitate annual reviews of the residents’ advance care plans. The convenience and quality of the practice has attracted 96% of residents to join the clinic, and the integrated information-sharing has lowered Kendal at Hanover’s hospital transfer rates, comparing favorably to other CCRCs with visiting physician services.

Integrated model facilitates aging in place

1) All data is Medicare. ED visits are 20 percent sample data from 2002 to 2006. Hospital use is 100 percent data from 1997 to 2006.
2) Refers primarily to the level of mutual information exchange and routine presence on-campus between CCRC staff and primary care clinicians.
Source: Bynum, Julie P.W. et al., “Fewer Hospitalizations Result When Primary Care Is Highly Integrated into a Continuing Care Retirement Community,” Health Affairs, May 2011; Kendal at Hanover; Post-Acute Care Collaborative interviews and analysis.