CareMore
CareMore was created in 1993 by a group of dedicated physicians who believed physicians should make decisions about healthcare -- not accountants. They knew proactive, coordinated care was smarter, healthier and far better than waiting to treat patients when they were ill.
The plan serves a population in which a third of the members are over 80 years old. Almost half live in households earning less than $20,000 a year. More than half are Hispanic, nearly a third are diabetic and nearly two-thirds are clinically depressed.
CareMore operates 11 comprehensive care centers in Southern California, which are models of coordinated, proactive, integrated health services and redefining the way senior health care is delivered. The centers offer individualized attention for members through innovative programs:
- Comprehensive medical evaluations by a geriatrician to provide evidence-based recommendations for a member’s present condition;
- CareMore members with diabetes receive free insulin, intensive podiatry care and comprehensive education and disease management services;
- Plan members receive complete mental health parity and can obtain mental health services with no referral requirement or co-pay;
- CareMore staff will purchase air conditioners for members struggling with heat-induced breathing problems from congestive obstructive pulmonary disease in order to avoid a decline in health and costly emergency room visits;
- Members with high blood pressure can conveniently transmit their daily blood pressure readings electronically to CareMore staff through a device on their telephones. CareMore staff will then closely monitor high-risk patients.
These are just a few examples of the specialized approaches CareMore initiates to advance a completely integrated and coordinated health care delivery system.
CareMore is able to provide rich benefits to its members because it effectively manages its medical costs. CareMore experts are dedicated to the healthcare of seniors and the medical staff is specially trained in the areas of senior healthcare and the physical changes and requirements for healthy aging. As a result, CareMore has seen tremendously successful clinical outcomes.
Coordinated Care Facts
In 2007, Medicare Advantage saved seniors nearly $90 per month or $1000 per year in out of pocket costs. An estimated savings of approximately $7 billion annually. Additionally, compared to traditional Medicare, Medicare Advantage plans can reduce out-of-pocket costs by up to $4,000 annually for patients with the highest healthcare needs.
- Comprehensive Care: Patients receive integrated treatment plans, and expert case management and disease prevention strategies for the chronically ill.
- Cost-Effective Care: Integrated medical groups are able to support investments in advanced healthcare information technology, tracking patient follow-through on treatment plans and patient outcomes, and helping to uncover health problems before they become catastrophic.
- Accessible Care: Efficiencies within the coordinated care delivery model mean better healthcare for more seniors, including:
• lower out-of-pocket costs
• increased health services such as dental care, vision care and preventive care
• reduced hospitalizations
• increased prescription coverage
• higher overall satisfaction rates
• greater value for the premium dollar than any other healthcare delivery system
What’s At Risk
If Medicare reforms dismantle incentives for coordinated care, seniors will experience significant increases in out of pocket costs - at a time when many seniors have seen their retirement account’s decline by over 40 percent in value — and decreased quality of healthcare.
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