New update on CareMore's innovative program to transform delivery of care for Medicaid consumers

Reviewed by Alina Shrourou, B.Sc. (Editor)Oct 7 2018

CareMore Health announced today that a new article "Rethinking How Medicaid Patients Receive Care" has been published in Harvard Business Review. The outcomes reported in the article provide the first update on CareMore's innovative program designed to transform the delivery of care for Medicaid consumers.

The findings showed that CareMore's high-touch, patient-centered care delivery program led to significant improvements in health outcomes and reductions in hospitalizations among patients in Tennessee and Iowa, which were the initial states in which the program was offered through the Company's Medicaid health plan partner Amerigroup. From May 2017 to April 2018, when compared to other Medicaid consumers in the same geography, CareMore's program demonstrated:

• Reduced Specialist Visits: Patients saw an approximately 25% reduction in specialist visits in Tennessee, and an approximately 15% reduction in Iowa.
• Fewer Hospital Days: In most populations across Iowa and Tennessee, patients spent fewer days in the hospital - ranging from 9.5% to 21.4% fewer days.
  • In the Aged, Blind or Disabled (ADB) Population in Iowa, there was an increase in hospital days observed as these patients are a very small and dispersed population and are without the usual CareMore extensivists teams deployed as they are in Tennessee, underscoring the valuable role that CareMore extensivists play in patient care.
• Decrease in Emergency Room Visits: Emergency room visits decreased by greater than 20% in both Tennessee and Iowa.
• Lower Hospital Utilization: All populations in Tennessee and Iowa saw a decrease in hospital admissions, ranging from 1% to 26% fewer admissions.

"Medicaid consumers have long been underserved due to well-established social barriers that make it difficult to provide comprehensive care to this diverse population," said CareMore Health President and article author Dr. Sachin H. Jain. "Where others may have seen a challenge, at CareMore we saw an opportunity to apply our model and provide these consumers with greater access to high quality care. Our success with this program demonstrates the opportunity for healthcare providers and care delivery systems to redesign and transform care for vulnerable patient populations resulting ultimately in a better healthcare experience and better health outcomes."

In 2015 CareMore applied its model of care to 20,000 Medicaid consumers in high utilization regions of Memphis, Tennessee, and Des Moines, Iowa. The program was designed using CareMore's health care delivery approach of going beyond the borders of traditional care to deliver common-sense solutions that meet the medical, physical and social health of consumers. To address the unique needs of Medicaid consumers, CareMore prioritized several strategies: hiring highly-skilled and compassionate people in all positions, incorporating behavioral and mental health offerings into consumers' health offerings, addressing the social needs outside of traditional health care in engagement with consumers and connecting hospital inpatient care to the community. Given the positive outcomes, CareMore is expanding its model to new geographies, including Washington, DC, Fort Worth, Texas and New York.

"These program outcomes demonstrate that CareMore and Amerigroup continue to deliver on the promise of providing the highest quality of care for our consumers, many of whom face complex health issues and social barriers to accessing healthcare," said Tunde S. Sotunde MD, President, Amerigroup. "Implementing novel care models and clinical innovations, as we've done in Iowa and Tennessee, will help us achieve our goal of increasing access to care while making the healthcare system easier to navigate for the consumers we serve."