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Health Care ‘Navigators’ Help Save in Costly ER Visits

Posted: May 28, 2012

EAST PALO ALTO, Calif. – Sosepa Tonga Tulua lost more than 100 pounds over the last year since she started taking cooking, gardening and Zumba classes at the Ravenswood Family Health Center here.

The 47-year-old credits a Tongan-speaking nurse at Ravenswood who helped her “navigate” the health care system and encouraged her to make some lifestyle changes soon after she was diagnosed as borderline diabetic a year ago.

“Coming from an island culture, I used to eat a diet heavy in meat. Now I eat a lot of salads, and am willing to make even more changes,” said Tulua, who has been able to prevent herself from becoming a full-blown diabetic.

Ravenswood has been engaged in this kind of work for months now, but a new transfusion of $7.3 million in federal money it received earlier this month will allow it to hire more culturally sensitive “navigators” to expand the program. This will help to save San Mateo County an estimated $6.2 million in health care costs over the next three years, said the center’s chief executive officer, Luisa Buada.

Ravenswood was “handpicked” for the federal grant from a nationwide pool of 3,000 applications by the U.S. Centers for Medicare & Medicaid Services (CMS), observed Congresswoman Anna Eshoo (D-Palo Alto) at an event last week to celebrate the federal grant. Of the 26 recipients of the grant, it was the only community health center.

Some 19,000 patients are expected to benefit from the grant to Ravenswood, the majority of whose patients are poor, and from Latino, Pacific Islander and African-American communities.

Buada said the additional staff who will be hired will help clients coming out of hospital stays to stay on top of their medication needs and follow-up medical appointments. That will prevent expensive visits to emergency rooms.

“Twenty percent of our Medicare beneficiaries go back to the hospital with the same problem they first went there with,” observed David Sayen, CMS’s regional administrator in San Francisco.

The grant is part of a $1 billion effort by federal officials through the Affordable Health Care Act program to reduce the cost of health care nationwide by emphasizing community clinics and preventive health care practices among the public.

The health care navigators on Ravenswood’s payroll will offer more classes in nutrition, cooking, exercise and other topics of health education for patients with chronic conditions.

Partnering with Ravenswood in the program are the Health Plan of San Mateo, San Mateo County Health System and Nuestra Casa. Together they will bolster a health plan to treat patients with such chronic health conditions as diabetes and high blood pressure.

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