This excerpt taken from the UNH 8-K filed Dec 19, 2006.
Winning Model in Attracting Enrollees and Spurring Innovation
MINNEAPOLIS (June 26, 2006) Evercare, a leading provider of health plans for frail elderly, disabled and chronically ill individuals in the United States, today announced that it has surpassed 100,000 enrollees across 35 states. For almost 20 years, Evercare has been dedicated to enhancing the quality of life and optimizing the well-being of its served populations, whether in the community or in nursing homes, through a variety of Medicare, Medicaid and private-pay long-term care plans.
Evercare CEO, John Mach, M.D. said, Our growth has been driven largely by our ability to meet the needs of people who require a holistic approach to their health that emphasizes coordination of multiple treatments, health maintenance and preventative care. Our focus is on keeping them healthier, avoiding trips to the hospital, and enabling them to function and live more independently. Evercares growth was also boosted by the advent of Special Needs Plans, which Congress and CMS created for better coordinated care of vulnerable populations.
Evercare was founded in 1987 by two Minnesota nurse practitioners who sought to reduce fragmentation in geriatric care by creating a model of care that emphasized collaborative relationships with their patients, caregivers and health care professionals. Their philosophy and shared passion laid the foundation for the nations largest single care coordination program for the frail elderly, disabled and chronically ill. The Company received Medicare demonstration status for its plans in 1995 and worked with state long-term care Medicaid systems to develop programs that integrate and coordinate medical, home and community-based services.
Chronically ill individuals with five or more medical conditions made up only 20 percent of all Medicare beneficiaries in 2004, but accounted for over two-thirds of the programs $302 billion in costs. In any single year, such beneficiaries are likely to fill up to 53 prescriptions, visit emergency rooms a dozen times or more, and require hospitalization at least five times. The traditional Medicare and Medicaid fee-for-service systems were structured primarily to provide acute care, not to meet the needs of the chronically ill through a coordinated approach. This fragmentation of care can lead to poor health outcomes that are draining for patients and physicians alike and are unnecessarily costly. In fact, according to a recent study that examined costs associated with caring for chronically ill seniors enrolled in Medicare between 2000 and 2003, $40 billion, or nearly one third of what is spent for their care, is potentially unnecessary. (Dartmouth Atlas Project, 2006)