Basic HTML Version
Healthcare Journal of NEW ORLEANS
I
MAR / APR 2013
31
going out to the homes and doing visits, but they were not pro-
viding clinical services, they were more administrative services.
They would go out, do an assessment, see what the needs were and
then we would get one of our contracted providers to get out and
provide the clinical services. The biggest change for us is we are
now hiring clinicians—nurse practitioners, pharmacists, nurses—
that are actually providing clinical services. That’s been an inter-
esting transition for us because we want to be careful that we are
not competing with our providers, but that we are enhancing the
experience, filling in gaps, and working as a team with them.
As an example, if one of our physicians has a patient that has
been discharged from the hospital and he would like to see them in
the office, but they just don’t feel well enough, we want him to call
us and ask us to send the nurse practitioner out to the home. She’ll
come back and report to him and they can decide what the next
step is for the patient. Our arrangement with the doctor is they
call and make the appointment with the patient. We always want
it to be that we are going out representing the physician. It’s not
the health plan seeing the patient, but we’re working together as
an extension of that physician’s office. That’s been a change for us.
Editor
Is there a noticeable difference between the New Orleans
and Baton Rouge markets?
Carol Solomon
There’s a big difference in the network. In Baton
Rouge, for example, you may have one or two GI groups or one or
two large ophthalmology groups that cover the whole city. Here
in New Orleans it tends to be smaller groups of two or three doc-
tors. I think Our Lady of the Lake and Baton Rouge General have
had their own physicians for many years and New Orleans is just
getting into that, with the exception of Ochsner. East Jefferson,
West Jefferson got into primary care physicians a few years ago,
but now they are also employing specialists. So I think that change
is happening in New Orleans, but Baton Rouge was a little differ-
ent. When we expanded to Baton Rouge that was a change for us,
but we have great relationships with our hospitals and physicians
there.
Editor
What’s next for you, professionally or personally?
Carol Solomon
We are excited about starting our own primary
care clinics. Two years ago we purchased the Stanicola Clinic in
Baton Rouge and got a taste of that. We’re opening our second pri-
mary care clinic on the Westbank in Gretna on the Ochsner hos-
pital campus. We have plans to open another four or five this year.
That’s our response to the shortage. As we look at our network and
want to grow we look at where we are lacking capacity for that
growth and we’ll put in a clinic of our own.
Being a physician-owned plan we are very sensitive to life from
the physician side of it and the changes they are going through,
such as changes to the electronic medical record, changing
to a new coding system. And also a lot of the regulations in the
Accountable Care Act are really getting them to do a lot of things
they don’t have the resources or manpower to do. That’s why you
are finding somany going towork for hospitals or somewhere else.
So we’ve put together a unit to help them transition to electronic
medical records. We did the analysis on the different systems that
were available. We chose one that we particularly liked and went
out to the primary care docs and said if you don’t have system,
and don’t have the time to look at what’s available, we’ve done the
The biggest change for us iswe are now
hiring clinicians—nurse practitioners,
pharmacists, nurses—that are actually
providing clinical services. That’s been
an interesting transition for us because
wewant to be careful that we are not
competingwith our providers, but that we
are enhancing the experience, filling in
gaps, andworking as a teamwith them.’’