Palo Alto Medical Foundation has high hopes for medical care in Santa Cruz

Santa Cruz Sentinel

SANTACRUZ — While federal courts are still sorting through legalities of the Affordable Care Act of 2010, the head of one of Santa Cruz’s major medical organizations said Thursday that new paradigms for health care have already arrived, residents are seeing changes locally and new industry partnerships will help manage costs.

Technology, a bigger emphasis on prevention, palliative care and cost accountability are just a few of the new missions laid out in preparation for changes in the industry, said Larry deGhetaldi, a primary care physician and president of the Santa Cruz Division of the Palo Alto Medical Foundation.

Speaking to a diverse crowd of leaders in business, education and health care, deGhetaldi said Santa Cruz is already seeing a better-informed, price-conscious health care consumer who uses electronic communication with a primary care doctor.

That consumer is less patient about waiting for services and more likely to forgo allegiances and shop the competition. Soon, that patient can expect to participate in group medical appointments and be a “wellness partner” with an employer.

“We don’t think it’s going to increase the workforce,” deGhetaldi said, but more people will get better services. “It sounds like magical thinking but others have done it.”

Electronic communication with foundation primary care doctors, which was made freely available to consumers this summer, has already resulted in lower costs because people now go online to make appointments, ask questions and check test results. Soon PAMF patients will be able to see their doctors’ schedules online so they can sign themselves up for appointments.

“This is something that scares the bejesus out of the doctors, but it’s going to work,” deGhetaldi said.

Santa Cruz County has the highest hospital costs in the country, largely due to wages, but also succeeds in keeping more people out of the hospital and keeping Medicare costs down, he said. “We’re doing something right,” deGhetaldi said.

Because about half of the nation’s medical costs are spent during patients’ last year of life, more cost effective palliative care is important, he said. Seven months ago, a six-person team was created to look after about 200 of foundation patients. The goal is to cut the number of hospital deaths in the Dominican Hospital intensive care unit in half.

“This is an experiment, deGhetaldi said. “We’re holding our breath. This will be a huge savings for Dominican.”

The audience included Becky Peters, executive director of Lifespan, who noted that climbing costs to provide insurance for 25 percent of about 110 employees was becoming harder for the organization.

“We take care of older people in Santa Cruz County,” Peters said. “We don’t want to pass that on to our clients. We are anxiously looking forward to 2014. Hopefully it will be better health care for our employees and benefits.”

Charles Canfield, Santa Cruz Seaside Co. president, said the company spends “upward of $2 million” on health care for about 175 employees, and he is very concerned.

The changes on the horizon, though complex, are hopeful, said several people attending the presentation.

“This is an incredible opportunity for the nation as a whole,” said Rachel Nava, chief operating officer of the Central California Alliance For Health, which administers Medi-Cal for Santa Cruz, Monterey and Merced counties. “I think it’s exciting. It’s going to be complicated. It’s an opportunity that’s never been presented.” The next frontier, she said, will be managing costs.

“Just the notion of having a health administrator believing it’s possible to reduce costs below the CPI consumer price index — was hopeful,” said Bill Tysseling, executive director of the Santa Cruz Chamber. “Overall what struck me was a sense of cooperation and less railing about things that are wrong. It’s so easy to be in room right now where it’s all complaining about the public sector or regulations or X, Y, Z, and that wasn’t the show here at all.”


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