Expanding Grand Rapids organization helps elderly people avoid costly ER visits

Life EMS Paramedic Marilee Bradford meets with Betty Katsma at her home in Wyoming as part of the TANDEM365 program. Credit: Courtesy photo

A partnership formed a decade ago in Grand Rapids that offers care to elderly people who want to remain in their own homes expanded into southeast Michigan this spring and plans to enter other markets.

Tandem365 began enrolling clients in Wayne County in April and expects to move into Ionia County this summer. In time, the home-based care provider plans additional expansions in Southeast Michigan and markets closer to home, such as Muskegon County in West Michigan.

“Our desire is to be a statewide program,” Chief Operating Officer Phil Fennema told Crain’s Grand Rapids Business. “Our goal is to touch as many lives as we can possibly touch.”

Senior living long-term care providers Sunset Senior Communities, Holland Home, Brio Living Services and BHI Senior Living, along with Life EMS Ambulance, formed TANDEM365 in 2014 to better care and serve elderly individuals who are ill and often in frail health.

Integrated Community Paramedic Marilee Bradford from Life EMS is part of an at-home care team that helps elderly or frail individuals stay in their homes and avoid costly trips to the emergency room. Credit:Courtesy photo

The organization coordinates medical, behavioral health and social services for clients, many of whom have multiple chronic conditions such as congestive heart failure, COPD, emphysema, dementia, kidney failure, Parkinson’s and diabetes. Oftentimes, the patients lack a social support network and need daily or weekly assistance at home.

By expanding into the Detroit area, TANDEM365 entered a market with a far larger population base to serve.

“There’s a huge need in Wayne County,” said TANDEM365 President and CEO Teresa Toland. “We felt like that was an opportunity not only for us but for the people that live over there having access to our services, which gets them connected obviously back to the community services, but also gives them support and safety.”

Tandem365 uses case managers, social workers, medical assistants, paramedics and RN’s to support clients at home. The organization then maintains regular contact with clients. If somebody needs assistance at home for a medical situation, they can call TANDEM365, which can dispatch a paramedic from Life EMS Ambulance to assess the person’s condition.

In 90% of the cases, the paramedic can address the issue in the home. If the situation is serious enough, the paramedic can then transport the individual to a hospital ER for further evaluation.

Designed to reduce costly ER visits for situations that are better handled outside of a hospital, TANDEM365 has more than 1,300 clients spanning six West Michigan counties:Kent, Ottawa, Newaygo, Montcalm, Allegan and Kalamazoo.

“Based on our experience, we knew there were some patients that didn’t need a full-blown paramedic response, but with no alternative, were being transported to the emergency department,” said Mark Meijer, founder and president of Life EMS Ambulance and the co-chair of TANDEM365’s Board of Directors.

Life EMS Paramedic Marliee Bradford checks the vitals of 89-year-old Richard Mackey of Tallmadge Township at his home as his wife, Barbara, looks on. Credit: Courtesy photo

Since starting 10 years ago, Tandem365 has served nearly 6,000 clients.
Clients typically come through referrals by case managers at Priority Health, the Grand Rapids-based health plan with 1.3 million members statewide, including about 266,000 enrolled in Medicare policies.
TANDEM365’s average client is in their mid 70s, although ages range from the mid 40s to individuals who are more than 100 years old.

Priority Health case managers often have “identified that something is wrong with the patient or that the patient is struggling with something, and they decide the program is a good fit” and refer them to Tandem365, Fennema said.

Since extending into Wayne County two months ago, TANDEM365 has enrolled about 40 clients and has about 500 people on a waiting list.

“We’ve just scratched the surface on the Detroit area,” Fennema said. “In that whole Detroit metro area — Detroit, Ann Arbor, even the Flint area — we could grow something similar to what we have here on the west side.”

The at-home care provider entered that market working with Ann Arbor-based ambulance service Emergent Health Partners.

Fennema knows some of the staff and leaders at Emergent Health Partners professionally. That connection led to TANDEM365 partnering with the ambulance service to begin serving clients in Wayne County.

“Emergent Health Partners offers services that are similar but not as comprehensive as TANDEM365 with its social workers and case managers who maintain regular contact with clients”, Fennema said.
“When it came for an opportunity to say, ‘Let’s partner on something,’ they were very eager to,” he said. “They saw it as an opportunity to go further than what they were doing.”

Quantifying exactly how many ER visits or hospitals admissions have been avoided has been a difficult equation, Fennema said. The organization estimates that for every two members enrolled, TANDEM365 has avoided one inpatient hospital admission, and one ER visit for every two to three members enrolled.

Priority Health has estimated that medical claims for TANDEM365 enrollees are $5,000 less than before they were involved in the program.

For some clients, the case managers and social workers with Tandem365 can help to bring together families to agree on care for an aging parent or loved one.

“You can actually work with the whole family … in their health care,” Fennema said. “We’ve served about 6,000 patients since we started, but it’s not really 6,000 patients because each one of them has a spouse and a son and a daughter. Those are kind of like our patients, too,because we have to deal with the patient holistically, which involves all their relationships.”

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