After recently being selected to insure village employees and their family members, Lovelace Health Plan announced its plan to open a primary care clinic in Los Lunas.
The clinic will be available for all of the nearly 500 village employees, their family members and anyone with Lovelace Health Plan insurance.
Coverage for village employees began July 1. The addition of the employees will mean Lovelace’s health plan now covers more than 10,000 people in Valencia County, according to Doug Gullino, the vice president of commercial sales and service for Lovelace Health Plan.
Gullino said the clinic will introduce a health care approach residents of the county probably don’t have available.
“It really gives folks access to medical care in a way we should have always been doing,” Gullino said. “It gives better care, better access to the whole system, to all the different services and providers we offer.”
Called a “patient centered medical home model,” Dr. John Cruickshank, chief medical officer at Lovelace Health Plan, said this is a change that is sweeping the country.
When he ran his private family practice for 18 years, Cruickshank said he would start his day double booked from 9 a.m. to 5 p.m.
“If we got a call at 1 p.m., we either had to triple book or we couldn’t see them,” Cruickshank said. “That model and experience in New Mexico caused trouble because of the access and availability of physicians. People were forced to go to the ER, which is a higher cost, and really just aggravating. And after treatment, the patient’s primary doctor might not be in the loop.”
One big change this “medical home” model will bring, is the allocation of a certain percentage of appointments reserved for same day access at the new Lovelace clinic, Cruickshank said.
“As much as two-thirds of the work is not done by a doctor — it’s done using a team-based approach,” he said. “And right now, if you come in with tennis elbow, all we’ll treat is the tennis elbow. Using the medical home model, you are treated for the injury, but we also make sure, say you have diabetes, that you are taking your medications correctly.
“In the past, treatment has been more episodic and fee-for-service. Now we are taking care of the entire health care picture, which is what the industry should have been doing all along.”
Cruickshank said the treatment model Lovelace will implement will also include registries of its patients, to track people with ongoing medical conditions, such as diabetes, high blood pressure and cholesterol, to ensure that they are staying compliant with medications and treatment.
“This is what we want to bring to the community,” he said. “Now that we have an employer, we are able to bring this change and model. We want good, efficient health care and this really pushes us to do that. Otherwise, how long would it take to bring this to the community?”
While the company looks at all regions in New Mexico to determine where the needs are to better serve the population, Gullino said discussions with the village prompted the decision to open a facility in Los Lunas.
“In talking with them about what they wanted, it became clear that having a primary care facility would be the best thing for them and everybody,” he said.
When asked about partnership with a potential Valencia County hospital, Lovelace Communications Manager Laurie Volkin said Lovelace “is always interested in helping communities,” but did not comment directly on whether the company would be part of a local hospital effort.
Gullino pointed out that Lovelace has a long history of partnering with local health care providers when its services come to a community.
“A great example is First Choice. In the last two or three years, they have used grants from Lovelace to develop their medical home model,” he said. “They are one of the groups who really understands the concept and builds beautiful facilities. They are committed to the model and have a strong connection with UNM, and they support the model as well.”
As far as services provided at the facility beyond primary care, Cruickshank said it’s still a little early to tell.
“It would make sense to have ancillary services, but what exactly those are will depend on the number of patients and the need. We don’t have hands around that yet,” he said. “We are very motivated to have services where they make sense and are committed to doing that analysis.”
The doctor said Lovelace has a partnership with Quest Diagnostics and the company has committed to putting a lab facility in the city of Ruidoso to complement Lovelace’s facility there.
Gullino said the company is still in the process of choosing a location in Los Lunas for the new primary care facility — an existing building or new construction are both considerations, he said, and both are feasible for the January 2013 opening date.
“There may be a provider here who wants to expand and likes the concept,” he said. “If not, we will bring someone in. It will be a Lovelace facility.”
Cruickshank said they are hoping to pull from local providers and find someone who fully supports the medical home model.
Cruickshank said the facility will obviously accept Lovelace insurance and will try to expand to take as many types of coverage as it can.
“I seriously doubt our competitors will send us their patients, but we would look to open it up and take as many comers as possible,” the doctor said.
Looking at employment opportunities, Gullino said it was also too early to tell what may happen.
“We have to look at getting physicians staffed and other services,” he said. “After that, we are open to what ever is going to fit the community’s needs.”
Lovelace Health System includes 11 retail pharmacy locations in Albuquerque, Rio Rancho and Santa Fe, as well as the system’s hospital network. That network includes Lovelace Medical Center, Lovelace Rehabilitation Hospital, Lovelace Women’s Hospital, Lovelace Westside Hospital, Heart Hospital of New Mexico at Lovelace Medical Center and Lovelace Regional Hospital-Roswell.
Lovelace Health Plan offers access to more than 8,000 health care providers and specialists across New Mexico and in bordering states.