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UNH » Topics » Providing High-Quality, Cost-Effective Care to Vulnerable Populations

This excerpt taken from the UNH 8-K filed Dec 19, 2006.

Providing High-Quality, Cost-Effective Care to Vulnerable Populations

Evercare has grown from 64,731 enrollees in December 2003 to more than 100,000 enrollees today by reaching out to individuals in danger of being overlooked by the health care system. Community enrollment totals nearly 70,000; and more than 30,000 nursing home patients are currently benefiting from Evercare.

Offerings include Special Needs Plans for those in nursing homes and for people with Medicare and Medicaid (“Dual Eligibles”) as well as Medicare Advantage plans for people with Medicare only living in the community; and integrated Medicare-Medicaid plans offered through states’ Medicaid programs. Evercare nursing home and community Special Needs Plans include Medicare “Part D” prescription drug coverage. EvercareTM Palliative and Hospice services support patients and families coping with advanced, life-limiting illnesses. Evercare also offers Evercare Connections EvercareTM Solutions for Caregivers, a service that helps people caring for an aging relative or friend navigate the health care system and obtain the appropriate care and services. Additional offerings include Evercare’s Health Plan for People on Dialysis.

Research demonstrates that Evercare’s approach to care results in greater access to medical and non-medical services, better health outcomes, and lower cost to the government:

 

  •   Health professional teamwork and continuity of care have been shown to help prevent some problems before they become serious – reducing hospitalizations for nursing home residents by 45 percent and emergency room visits by 50 percent. (Journal of American Geriatrics, 2003.)

 

  •   Evercare nursing home patients were seen more by their physicians than their peers enrolled in other plans. While they were also hospitalized half as often as their counterparts, Evercare enrollees were more satisfied that they would be hospitalized when necessary. (CMS Outcome Study, 2002.)

 

  •   Through the Texas STAR+PLUS program, Evercare helped reduce hospitalizations by 22 percent and ER visits by 38 percent, and 90 percent of enrollees said they were satisfied with their care coordinators. Evercare also helped the state government save $123 million in Harris County over two years. (Texas A&M University, 2002.)

 

  •   As of June 2003, over 60% of elderly and physically disabled individuals enrolled in the Arizona Long Term Care System programs (like Evercare) were able to live independently in their communities, avoiding nursing homes and compared to 5% at the inception of the program in 1989. (State of Arizona Claims Data, 2003)

 

  •   In Florida, vulnerable populations enrolled in Nursing Home Diversion programs, like Evercare’s community plan, were nine times less likely to enter nursing homes for an extended stay. (Florida Office of Program Policy Analysis & Government Accountability, 2006)
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