Dr. Carol Stewart-Francisco got into the field of medicine because she has a calling to be a healer, to help people stay healthy and, particularly when it comes treating older patients, to help them better understand their chronic conditions and manage any disease they may have so they can enjoy better quality of life.
Yet like many primary care physicians who hang out a shingle, Dr. Stewart-Francisco found herself dealing more with administrative duties – a seemingly endless mass of paperwork including sometimes frustrating correspondence with insurance companies, and an avalanche of records necessary not only to track patient health, but also to receive just compensation from payers for her treatment.
“It was very difficult,” said Dr. Stewart-Francisco, who has practiced for years in Rosemont and Longwood. “What’s needed to run a practice today distracts from the practice of good medicine. It gets in the way of building a good relationship with my patients, which is vital to being a good, effective physician.”
Last year, Dr. Stewart-Francisco made a decision to join WellMed, a physician-led and physician-founded healthcare delivery system. By doing this, she continues working in the community she calls home, specializing in patient care of seniors which is one of her passions. Yet the contract with WellMed Medical Management of Florida offers many advantages to her and her Physician Assistant Metasebia Bekele, not the least of which is freedom from much of the bureaucracy of the business of healthcare.
“We have much more time to see patients now,” Dr. Stewart-Francisco said. “We have support at our clinics for billing and electronic record-keeping and much more. It is amazing how much is missing from your patient involvement and contact when your attention must also go to office upkeep.”
Dr. Stewart-Francisco joined a growing cadre of physicians in Florida who are getting to know WellMed. For more than 20 years, the healthcare company has earned a reputation for excellence in care of Medicare-eligible patients — mostly seniors — and in the development of highly effective practice management to allow physicians to better care for their patients.
Expanding to Serve Seniors Better
“At WellMed, we are very excited about expanding primary care options for Medicare-eligible seniors in Florida,” said Dr. George M. Rapier III, Founder and Chairman of WellMed Medical Group. “Research shows WellMed patients live longer thanks to our focus on managing disease, preventive medicine and increased access to healthcare. Providers at these clinics are equally committed to the WellMed vision to change the face of healthcare delivery for seniors.”
With a presence at health fairs, special events targeted to the senior market, informative WellMed doctor-led health radio talk shows and growing social media campaign, WellMed is becoming a household word for better senior care. In the past year WellMed has opened new primary care clinics in the Orlando and Tampa regions, and has had four clinics operating in the Treasure Coast since 2008. For the most part, WellMed partners with preferred Medicare Advantage plans to offer a robust suite of healthcare services to older Floridians.
“As a WellMed doctor I can provide patients with a social worker who will visit them within 24 to 72 hours of being released from a hospital stay to help with things like medication management,” Dr. Stewart-Francisco says. “This wasn’t a service I could offer patients in my solo practice. “
Some of the advantages doctors and patients enjoy with WellMed occur behind the scenes says Dr. Tia Hooper, Medical Director for WellMed Florida.
“WellMed doctors have the resources and manpower to intercede on a patient’s behalf if an insurance issue needs to be resolved,” says Dr. Hooper, who has been with WellMed for seven years. “A WellMed contracted physician can call on us to help a patient, say, who may run into problems getting an electric wheelchair. We can intercede on their behalf and keep the doctors free to do what they do best, caring for their patients. This extension of care through WellMed Medical Management is especially important for seniors who may no longer be as independent as they once were or who may not have family or other support to assist them with these day-to-day issues.”
WellMed’s mode of care promotes a more intense level of patient involvement that what is normally associated with seeing the family doctor. “In some areas, patients need a lot of self-management and education to help them stay independent at home. Self-management is key to helping our patients stay well and out of the hospital,” Dr. Hooper says. “WellMed gives them the tools to manage their disease, whether it be diabetes or recovering from surgery at home. The basic philosophy of the WellMed model is to give the patients the time they need at an office visit and help them understand how to care for themselves at home. More time with each patient is critical in the elderly population.”
Helping Doctors, Helping Patients
WellMed Medical Management, with more than 2,000 employees, supports physician and patients through services such as office and billing support, electronic medical record and patient data reporting, care coordination, preventative education services, social workers and other networked support services.
The WellMed business model is to provide a concierge level of quality, proactive health services to seniors, placing the emphasis on preventative care while building a close provider-patient relationship for better patient communication and best medical results. Because WellMed largely works under a capitated business model, accepting a set amount of money per patient per month to care for their needs.
This model encourages innovation in the healthcare system and emphasizes preventive healthcare. By investing in patient health on the front end, WellMed helps patients stay out of hospital. Our patients are circled with a medical home that embraces them in a patient centered medical home
This model has paid off for WellMed physicians and their patients. In 2011, a federally funded, independent peer-reviewed case study by the Robert Graham Center studied health results of tens of thousands of WellMed Seniors in the San Antonio area. Results of the study showed that WellMed patients, on average, are less likely to be hospitalized or re-admitted to the hospital than their peers. They are older and live longer than the general population of those 65 and older in Texas.
Much has to do with our mission of changing the face of healthcare for seniors. Our model is unique and is a mainstay of all of our care. Our doctors participate in:
- Daily Team Huddles
- Risk Stratification Systems
- Transitions Management
- Weekly Patient Care Coordination (PCC) Meetings
Building better healthcare for seniors
San Antonio physician and WellMed founder Dr. George M. Rapier III has long believed there is a better way to provide seniors with a full spectrum of primary healthcare and healthcare-related services, with special attention to more chronically ill patients. With the number of primary care doctors already shrinking, wait times to see a doctor growing and time with a doctor during a visit almost disappearing, Dr. Rapier envisioned a healthcare model for seniors that would give them the expanded care and services that they deserved in their golden years.
Starting with some seed money from PacifiCare, Dr. Rapier started WellMed with a single clinic in the San Antonio (TX) Medical Center in 1990 and has since grown it into a diverse healthcare delivery system with more than 70 primary and multi-specialty clinics in Texas and Florida, and providing practice management services supporting 4,000 independent physicians. WellMed directly provides healthcare services to more than 100,000 patients, mostly Medicare-eligible seniors.
Today, the healthcare delivery system that Dr. Rapier built has a name that is all the rage in the medical field – the “patient-centered medical home.” “There was not enough primary care even then and I just knew that there was a better way to take of our senior population,” said Dr. Rapier, named Modern Physician’s “Physician Entrepreneur of the Year” in 2009 creating a company that takes better care of patients, gives providers the support they need to do just that, and makes money doing it.
WellMed clinics or contracted doctors can offer their patients individual case management, tailored to suit the needs of each patient. Social workers are assigned to patients who need at home care following procedures or surgery to help with medication management and other needs. Meetings are held with family members to educate them on best care of their loved ones. Complimentary health education classes help patients further understand and manage their conditions, making them feel part of a team dedicated to their healthcare.
“Because we don’t operate on a fee-for-service model, we have the ability to really give patients what they need both in preventative screenings and education and in home when needed,” Dr. Hooper said. “Our goal is to manage healthcare costs effectively and keep our patients well and out of the hospital.”
WellMed avoids what Hooper calls “fragmented care” of a patient. The patient and their caregivers are fully engaged in that patient’s care and are more educated as a result. The doctor-patient communication at WellMed is better and so the result is better for everyone. “It is a model that works and the medical home concept, especially in primary care, continues to be the wave of the future.”
WellMed entered the Florida market on the Treasure Coast and in the past year has expanded with WellMed clinics in downtown Orlando, the communities of Lake Copeland, Rosemont, Longwood and in Kissimmee at Oak Commons. WellMed also has a presence in the Greater Tampa region with clinics now serving Bartow and Southeast Lakeland. In all, WellMed opened 18 new clinics in Texas and Florida last year, and is on pace to beat that number in 2013.
Orlando Market Expansion Adds Thousands of New WellMed Patients
With three wholly owned WellMed clinics and more than 100 contracted WellMed providers in the Orlando area, Florida expansion has a strong foothold in the senior healthcare market.
Dr. Emmett Kenney, Regional Director for WellMed in Orlando, said that the Florida expansion, from 2008 to present day, has doubled the number of patients in WellMed’s care. “Future plans include WellMed clinics in Florida’s largest retirement havens, The Villages in Lake County, and on the West Coast of Florida. Finding the right doctors to invite into the WellMed family is our focus. While each doctor must share the same goals and values of WellMed, we work with each doctor or physician’s group independently,” Dr. Kenney said.
WellMed has a transition team that assists in the process of going from independent practice to either a WellMed contracted doctor or by turning a group practice into a WellMed clinic. “Bringing in WellMed at any level enhances a doctor’s ability to offer patients the best in service and treatment goals. It is difficult to run an office efficiently while at the same time giving your all to your patients. With the shift to the new Affordable Care Act provisions, staying on top of daily changes is demanding. Fee structures and Medicare payments are an area that doctors must continually be aware of. It is my job at WellMed to ensure doctors who consider joining us – either as contract physicians or as an owned clinic – that we take those pressures off of them and let them know that they will be paid fairly. That eases the stress of having to limit their time with patients.”
There is a transition process for patients, too, when they choose a WellMed doctor. Seniors need to know that WellMed is a trusted source for their healthcare. Dr. Kenney points out that many simply don’t want to change doctors, but they like the added services WellMed provides. “When a patient decides to choose WellMed for their care, we spend a lot of time making sure that they know they have made the right choice. It is evident from our model that we are interested in their care from the first visit,” Dr. Kenney notes.
The foundation for the team is the functional Patient Care Conference (PCC). PCC is the weekly meeting where the care management and clinical teams get together and discuss progress and barriers for certain patients. They also discuss inpatients and how they are progressing in the Transitions program.
The Functional PCC is event driven: something happens to the patient that makes them come in front of the team. These events tend to be more episodic, such as an ER visit, hospital visit, or a determination by the team, with what they know about the patient, feels that they are at risk. It optimizes the care planning, care taking, and communication to reduce those events. In a Functional PCC, this is a safe environment where critical discussion and thinking takes place to improve patient care (nurture vs. confrontational).
What Can a Patient Expect From WellMed?
In Lakeland, Dr. Pedro Ruiz and the providers in his clinic agreed to the join WellMed healthcare delivery system a year ago. So far, they are happy with the transition.
“WellMed has the most efficient transition team and process that’s available,” Dr. Ruiz said. “We had to become certified as the ACHA (Florida Agency for Health Care Administration) has strict rules that WellMed has to follow for transitioning a private practice into a clinic. A site visit was conducted to make sure that we followed all procedures. There is important criteria to follow, and now we are a fully certified WellMed Clinic,” Dr. Ruiz said.
Dr. Ruiz noted he and his team made the decision to join WellMed largely for the benefit of their patients. “Small offices like ours can’t provide all the services patients need,” he said. “The senior population is growing and the need for primary care physicians is great.”
After nearly a quarter-century in solo private practice, Dr. Alicia Saunders came to a similar conclusion and converted her practice in Bartow to a WellMed clinic last year. Trained in Argentina and Puerto Rico, Dr. Saunders said she saw beauty in the WellMed approach to patient care, which offers robust preventative care programs for all patients.
“The social problems that we have today are really, really awful. There are too many people with no insurance or too little insurance,” said Dr. Saunders, Board Certified in Internal Medicine. “Bartow is a small community and a lot is needed here. At WellMed, patients can be sure to receive a great deal of attention from their doctors, much more than if they are seeing a physician who is trying to do everything on their own.“
Dr. Harpreet Patheja, an Internal Medicine physician at the Lakeland clinic, added that a doctor who is considering transition from a private practice to a WellMed clinic couldn’t ask for a better prepared corporate transition team.
“There are always bumps in the road with such a huge undertaking. WellMed is very good at spotting problems in the practice and correcting them going forward. As a physician, I was very satisfied with the benefits that WellMed offers patients.
From their “First Touch “ visit, a concept exclusive to WellMed, a patient is given a tour of the facility, meets the team that will be treating them, has blood work and labs plus screening tests (neuro, breathing, vascular), and talks with their doctor about follow up visits. “Our office staff has time to collect their medical records so they are fully prepared by their first visit to walk in and see the doctor,” Dr. Patheja says. ”There is no time wasted at the first visit because results from their First Touch visit are ready for review.”
“I love this concept. We have become their medical home for everything.”
To learn more about WellMed, either as a patient or physician, contact 1-888-781-9355
By Cherie Faircloth