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Helping Medicare patients navigate surgical care

By The Health News Team | January 11, 2022
Retired California State Assemblywoman and State Senator Dede Alpert.

Recovered from her recent hip surgery, retired California State Assemblywoman and State Senator Dede Alpert has returned to her love of golf.

When retired California State Assemblywoman and State Senator Dede Alpert noticed some pain in her hip while playing golf last spring, she did what most people do: visited her doctor.

However, when the hip pain failed to improve and became more severe, Dr. Joseph Hong, a board-certified sports medicine doctor with Sharp Rees-Stealy Medical Group, ordered an MRI of Alpert’s hip, which revealed she would need hip replacement surgery.

With surgery on the horizon, Alpert, immediate past chair of the Sharp HealthCare Board of Directors, would soon discover a key benefit to being a Medicare Advantage patient. She would receive coordinated and thorough care before and after her hip surgery, thanks to the Utilization Management Surgical Complete Care program, a Sharp Rees-Stealy program that shepherds patients through intricate surgeries.

What is Surgical Complete Care?
The Surgical Complete Care program is still in its infancy but already proving to be successful. For just over a year, the program has been helping Medicare Advantage patients who are scheduled to have podiatric or shoulder surgery, amputations, and knee or hip replacements. The program also provides services for complex surgeries, such as colectomies and ileostomies.

Shana Larson, LCSW, a case manager for the Surgical Complete Care program, guides patients through all types of surgeries, from the routine to the more complicated.

“It’s great to talk patients through what to anticipate, as they prepare to go into surgery, what to expect from physical therapy, and through all their follow-up appointments,” Larson says. “And it’s nice for patients because they have one point of contact. Many times, patients have asked me, ‘Is it normal to be anxious about my surgery?’ We’re here to answer these types of questions and concerns.”

The main goal for the Surgical Complete Care program is to arrange for the services that will be needed by the patient after surgery. By performing these services prior to hospitalization, the patients are less anxious and can return home knowing what the entire scope of their surgery journey will entail. Also, the Surgical Complete Care team provides additional support throughout the surgical process and, as Larson mentions, acts as principal contact for the patient.

As the patient navigator for the process, Larson provides a warm handoff between the doctor’s office and any care provided after patients go home. She assists with pre-operation needs, orders required medical equipment such as walkers, and arranges for skilled in-home nursing, as well as physical therapy, both in-home and outpatient.

“Shana made sure I had everything I needed and that I was taken care of every step of the way,” Alpert says. “She even gave me printed exercises and information on how to prepare for surgery.”

Once the patient is back at home, the team from Surgical Complete Care will maintain contact with them to determine if there are any issues. If there are no issues after the surgeon’s follow-up, the program rounds off services, and the patient begins their road to recovery.

The road to recovery
Alpert’s time in the hospital was minimal. She had surgery on a Monday — performed by Dr. Joseph Jankiewicz — and was back home the very next day. And she can’t say enough about the care she received.

“Sharp Rees-Stealy does an incredible job with managed care and they should be proud of what they do for their patients,” says Alpert. “I’m definitely proud to have them as my health care provider.”

Today, Alpert is recovering well, continuing physical therapy at Sharp Rees-Stealy Rancho Bernardo and already experiencing pain-free days. She’s even returned to her love of golf. “I’m now venturing out to the putting green again and in a few short weeks, I look forward to being back on the links!”

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