Medicare Issues
XLHealth Participating in Briefing to Address Management of Complex Medicare Populations
By
Jan 27, 2012 - 10:52:50 AM

Presentation to highlight how proven model of care impacts outcomes for dual eligible beneficiaries with chronic illnesses

(HealthNewsDigest.com) - BALTIMORE, Jan. 27, 2012 -- XLHealth, the nation's leading provider of health plan solutions for Medicare beneficiaries with special needs, is one of four organizations participating in a Capitol Hill briefing being held today focused on supporting dual eligible beneficiaries with complex health conditions. The event, "Health Plan Innovations: Caring for Medicare and Medicaid Patients with Chronic Illnesses," will include valuable insights on innovative programs that improve health outcomes and reduce costs.

Effectively managing care for Medicare beneficiaries with chronic illnesses is a key strategy in reducing health care spending, highlighted by a new federal report indicating that 5% of the nation's sickest individuals -- many of which are enrolled in Medicare -- account for almost half of all health care spending. A recent XLHealth study published in Health Affairs highlights the company's model of care and its ability to improve care for such Medicare beneficiaries. Specifically, the plan increased primary care services by 7% and lowered hospital admission rates by 9% when comparing diabetic plan members with similar beneficiaries enrolled in fee for service Medicare.

"We have found that the best way to manage the care of individuals with complex needs is to identify gaps in care upfront, and promote primary and preventive health care through frequent, direct contact with the member," said Laurie Russell, M.S., R.N., C.C.M., G.C.M, XLHealth's vice president of quality strategy and outcomes. "Our goal is to maintain a constant and precise awareness of our member's health so that we're able to identify any issues that might result in unnecessary hospitalization."

Care management innovations to be discussed at today's briefing include:


-- HouseCalls: Annual and post discharge in-home visits by a doctor or
nurse practitioner where urgent health problems or potential health
risks are identified.
-- Nurse Care Management: Ongoing support for members from plan nurses
including a 24/7 nurse hotline.
-- PharmAssist: Personalized, private counseling sessions with
specialty-trained plan pharmacists to help manage medications, identify
potential problems, and make recommendations to help improve care.
-- Social Support: Helping plan members access federal, state, and
community level programs that provide assistance with health care costs
and daily living needs.
-- Transitions of Care: Transitional support through plan nurses and social
workers for members and their caregivers when discharged from the
hospital or moving to a new care setting.


The complete study, "Medicare Advantage Chronic Special Needs Plan Boosted Primary Care, Reduced Hospital Use Among Diabetes Patients," which was conducted by XLHealth in partnership with America's Health Insurance Plans, is available via the XLHealth website at: http://www.xlhealth.com/newsroom/inthenews.aspx





About XLHealth CorporationXLHealth Corporation (http://www.xlhealth.com) is the owner and operator of Care Improvement Plus (http://www.careimprovementplus.com), a Medicare Advantage health plan committed to delivering quality health care benefits and serving the underserved. Focused on improving patient outcomes and reducing health care spending, Care Improvement Plus provides comprehensive Medicare coverage and a Part D prescription drug benefit, plus additional services such as dental and vision coverage, and care management support.

Web Site: http://www.xlhealth.com

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