For older adults struggling to access health care, whether it’s treating an existing illness or screening for an undiagnosed condition, nothing is more important than having a care team that knows their background.
Dr. Sara Fontanez is a family medicine specialist at Oak Street Health® Primary Care Office in Brooklyn, New York. Oak Street Health, a CVS Health® company, is dedicated to caring for older adults. Fontanez spends her days meeting with patients, learning about their unique medical needs, and helping develop care plans. The first patient she saw had spent most of his life incarcerated. He has had very limited interactions with medical professionals, many of which have not been positive.
“When we first started living together, it had been years since he had seen a primary care doctor,” she said. After meeting him, Fontanez learned he had several medical conditions that put him at high risk for hospitalization, including high blood pressure and COPD. So she took the time to analyze his condition and ordered several tests to determine the way forward. “I think by building that initial trust and seeing him often, we were able to build a relationship,” she explained.
Personalized preventive care model
Oak Street Health offers an extensive network of clinics and medical services ranging from primary care and immunizations to cancer screenings. Each patient at Oak Street Health is paired with a dedicated team who takes the time to learn your medical history and health needs. New patients will have 40 minutes to meet with the doctor during their first two visits. Patients will then be scheduled to return monthly for tests and consultations. Meanwhile, the team works seamlessly behind the scenes to create a personalized care plan for each patient.
“We see patients more frequently than any traditional practice,” Fontanez explained. “We see some of the sickest people, people with really complex needs, people who are in and out of the hospital every month, which is unheard of in traditional primary care practice.”
And this method makes a big difference. Prior to joining Oak Street Health, Fontanez was a hospitalist working in inpatient care. She has frequently seen people end up in the hospital due to lack of access to primary care. For those with a primary care physician, a lack of communication between doctors and hospital staff could complicate the situation. To avoid such disruptions before they even begin, the clinic has a team dedicated to supporting patients, ensuring that all their needs are met, especially after admission.
“Our main goal is to see patients here in our office within a week of discharge,” Fontanez said. “That’s why Oak Street Health has a team out of the office that follows up with calls to patients to ensure medication adjustments are made.”
Breaking down barriers to care
Oak Street Health is dedicated to meeting patients where they are, both physically and financially. The clinic treats seniors regardless of income and accepts most major insurance plans, including Medicare and Medicare Advantage. Oak Street Health builds state-of-the-art clinics in underserved areas, making it easier for seniors to access hospitals.
This is one of the things Fontanez is most excited about about being part of Oak Street Health. Because she knows her patients are receiving the dedicated care they deserve.
“I think we’ve been very strategic about putting centers in low-access areas, and I think that can be really transformative for a lot of communities,” she explains. I did. “I’m happy that more patients will have access to this level of care, which I think they deserve, and I’m also excited about how more value-based care will actually change our health system.” I’m looking forward to seeing how it can transform.”
To find a clinic near you, visit OakStreetHealth.com.
