Sarah Burks was a bit heavy three decades ago, while a student at South Park High School, but her weight took a slow, steady climb in the years that followed.
A diet anchored by fried chicken, hamburgers, French fries and soda pop combined with a work life on her feet in grocery and department stores, on farms, and, for about a decade, as a certified nursing assistant.
"I used to eat out a lot, eat lots of fast foods,” she said. “I was a Pepsi-aholic. I don't do that anymore.”
Burks, 55, lived most of those years outside New York City. She returned to Buffalo about a dozen years ago for a new job but things went south during her physical exam. Her blood pressure registered an alarming 170/100. She was nearly blind in her left eye. Obesity had taken a toll on her knees and back.
She has since been jobless, on disability assistance, but these days Burks talks about returning to work, thanks to a new wellness program set up last fall on the West Side to lift her and others on Medicaid to better health.
The program uses a combination of medication (if needed), exercise and cooking classes to get results. It also serves as a reminder as the holidays begin, and the new year approaches, that a straightforward wellness plan can lead to improved health, more energy and greater peace of mind – if we stick with it.
When you research successful treatment of obesity and chronic health conditions, “it's always going to come down to a balanced model of eating and healthy activities," said Dana Ingebretson, a registered dietitian and nutritionist with the program.
The Greater Buffalo United Accountable Healthcare Network (GBUAHN) established the Wellness & Physical Fitness Program that has helped Burks and hundreds of others get back on track.
Many, including Burks, are patients at Urban Family Practice, which shares space with the network at 564 Niagara St., Building 2. The primary care operation tends to the life and health needs of 8,000 people with a staff of 240 which collectively speaks a dozen languages.
The wellness program started in September 2017. It has since helped reduce emergency room visits by its members by 67 percent; hospitalizations by 80 percent.
A three-month study of those in the program with Type 2 diabetes showed their average A1C blood sugar levels fell by 0.6 percentage points – a drop equal to the impact that can be made by a $280-a-month drug, said Dr. Raul Vazquez, the primary care doctor who leads Urban Family Practice.
The practice and GBUAHN are in partnership with the Greater Buffalo United Accountable Care Organization (GBUACO), a network of Medicaid-affiliated health providers that work together in a patient-centered care model to avoid duplication of services, including medical testing, which lessens patient confusion.
Providers work on a "value-based payment system," in which doctors and other health workers are rewarded for preventing ER visits, hospitalizations and re-hospitalizations.
"Instead of getting paid for the quantity of tests you order and quantity of visits to the doctor, they're paid on quality, on the outcomes," said Julie Doerr, assistant director of marketing with Urban Family Practice.
The partnership provides transportation to patients when needed. Care coordinators work with patients between office visits to make sure they’re taking medication and, if it’s recommended, are participating in the wellness program. They also work to connect them to other health, housing and community resources as needed.
If patients reach or maintain healthy blood pressure and blood sugar numbers, as well as other sound medical outcomes, the providers get to share in health insurance cost savings.
Vazquez said the strategy has proven far more effective than telling patients they have hypertension, advising them to eat a low-salt diet, handing them a prescription and a pamphlet, and showing them the door.
“If you're engaging people and they understand the issues, they're more inclined to help with the solution,” Vazquez said. “In the long run, it saves a lot of money in the Medicaid system. Six million people in New York State use $60 billion in Medicaid a year,” almost one-third of overall health care spending in the state.
Burks doesn’t have diabetes or high cholesterol but has managed, with help, to bring her high blood pressure into the normal range. She is not alone in the program, either.
The American Heart Association recently awarded Urban Family Practice Target: BP gold status for helping to control blood pressure for more than 70 percent of its patients.
The practice worked with YourCare Health Plan – a Medicaid insurer – to track patients from April to June. Half of practice patients with the insurance had normal/borderline blood pressure (140/90) at the start of the study, compared to 72 percent by the end.
Type 2 diabetes and high blood pressure can lead to health complications that include heart and kidney disease, stroke, nerve and eye damage, hearing loss and dementia. Obesity and inactivity are risk factors for both; while smoking and excessive alcohol use also can lead to high blood pressure.
About 200 Medicaid patients use the wellness program in the building’s basement each week – and so do those who work there, including Vazquez.
"When I come down here, people are having fun,” he said. “It's almost like communities have lost this kind of connection, so what we do here is kind of critical. Sometimes, you're having a bad day, you come here and talk to somebody and you feel better."
Burks visits the network fitness center four times a week, doing an hour of cardio and 20 minutes of strength training each time. She and others also take nutrition classes in a training kitchen.
Since last year, her weight has fallen from 389 pounds to 347 pounds. She is determined to lose more. Her energy level has climbed, she cooks at home now and she has completely rearranged her diet.
"I've learned how to balance my meals – less fatty foods, less fried foods, more fruits, vegetables, less starch, less carbs,” Burks said. “I've changed my portions and started working out. My knees don't hurt as bad as they used to."
Dizzy spells, shortness of breath and bad headaches that once dogged her also are gone.
“I can run my grandkids down now, which I couldn't do before,” she said. “I just feel so much better.”