Caring for a Graying Village

Apr 08, 2014 at 12:00 am by Staff

 New Health Specialty Care Center in the Villages

THE VILLAGES – The nation’s largest 55-and-up retirement community is fertile testing ground for cost-savings healthcare initiatives as American medicine shifts from fee-for-service to fee-for-quality.

USF Health partnered with The Villages in 2011 to create a national model of coordinated healthcare for optimal health in retirement, with a goal of transforming it into “America’s Healthiest Hometown®.”

On a chilly morning in late January, USF President Judy Genshaft celebrated a milestone in that journey by officially opening the USF Health Specialty Care Center in The Villages. USF Health doctors staff the new 25,000-square-foot facility.

“We’re excited to see USF Health extending the benefits of an academic health center – all the latest, most cutting-edge research, education and care – to serve residents in a new region of Florida,” Genshaft told an eager and curious crowd.

The USF Health Specialty Care Center is designed to align with The Villages Health primary care centers being built in the 5-square-mile community to provide a model of seamless, coordinated healthcare. It houses 32 exam rooms and four procedure rooms, with the ability to provide onsite laboratory work, ultrasound, stress echocardiography, cardiac nuclear stress tests and other tests. Specialties include obstetrics and gynecology, cardiothoracic surgery, plastic and reconstructive surgery, orthopedic surgery, endocrinology, and general surgery.

“We’re already hearing great things from our patients about the opportunity to visit the center,” said Elliot Sussman MD, chair of The Villages Health. “Having specialists aligned with USF Health available right here in The Villages is vital to our patients’ health, convenience and peace of mind. We look forward to working with the health professionals at the Specialty Care Center to provide our patients with a full range of healthcare and services … just a few steps away from home.”

Work began last year on the new specialty center, following analysis of the USF College of Public Health’s comprehensive health needs survey of the The Villagers, the largest such survey of an aging population. Nearly 40,000 responded.

“What makes this center so wonderful is that it truly began with residents of The Villages,” said Donna Petersen, ScD, MHS, CPH, interim senior vice president of USF Health. “It began as we built our partnership with this community. We asked residents, ‘What do you need to improve your health?’ And you shared your vision. You want a more coordinated network. You want a healthcare system that works for you – not one where you have to ‘work the system.’ We set out to create the patient-centered medical home of the future in The Villages.”

The university’s statewide initiative at The Villages also includes onsite health seminars, assessments and other services. The unique partnership provides residents of The Villages the benefits of an academic health center with high-level specialty care and access to the latest clinical trials.

“Creative partnerships will provide insight into solutions that improve healthcare,” said Jeff Lowenkron, MD, CEO of the USF Physicians’ Group. “This care will be integrated and coordinated by design, not by accident.”

The Villages’ developer, Gary Morse, moved with his dad from Michigan to Florida in 1983 to sell homes with a special pitch: free golf. Snowbirds helped sales reach $40 million by 1987, and grow the close-knit community to 3,500 acres by 1992. Now stretching across more than 20,000 acres and three counties, The Villages is expected to accommodate nearly 60,000 homes by 2018.

The timing for experimentation is ripe. By 2020, statisticians project that 45 percent of American households will be headed by someone at least 55 years old.

The Villages’ “aging in place” concept has taken flight across the United States, with nearly 200 “village” programs on track or in the works. (The “village” network doesn’t include The Villages in Florida.) Their common goal: helping people stay in their homes through their 70s and 80s and, in a growing number of cases, into their 90s.

Among their goals, “village” programs aim to provide low-cost medical care. So far, these efforts have been fragmented and minimal. For example, in Madison, Wisc., a program called SAIL (Supporting Active Independent Lives) works with a geriatric pharmacist and university pharmacy students to provide personal health coaching to its members.

“Older adults are oftentimes overmedicated,” SAIL executive director Ann Albert has said. “They’re taking medications that over the years can build up in their systems, and have interactions that maybe a 40-year-old or 50-year-old person wouldn't experience.”

In an intensive screening program aided by volunteer pharmacy students, four of five 30 SAIL members tested were identified with adverse drug reactions.

“Just in our home county alone, more than 1,500 seniors are hospitalized each year because of adverse drug events,” Albert said, noting the free screenings could produce significant savings for Medicare and Medicaid.

In a San Diego “village,” ElderHelp, a philanthropically-supported social agency, is testing a unique model that provides significant support services to a largely lower-income group of seniors. Members support the services through annual dues. However, the classic village model works in affluent neighborhoods, but not so well in lower-income communities. The mission is to demonstrate the village model’s cost-effective solutions that government programs have traditionally provided.

“Our vision is to make the villages a model that's going to make an impact by serving an older population that has a higher level of chronic disease and a higher level of need, but is lower-income,” ElderHelp executive director Leane Marchese has said.

Even though these small efforts have helped nationwide, The Villages project that started the grass-roots movement has grabbed the spotlight.

“We’ve even had venture capitalists come see how we’re going to serve 90,000 people,” said Stephen Klasko, MD, Dean of the USF Morsani College of Medicine and CEO of USF Health from 2004 to 2013.

Klasko considers The Villages partnership among the university’s greatest achievements during his time at USF.

“It’s probably the nation’s first true university-community partnership,” he said. “It’s very, very exciting.”

Editor’s note: Medical News’ series on The Villages’ goal as a national healthcare model continues next month with Jeff Lowenkron, MD, CEO of the USF Physicians’ Group.

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