Health Affairs Study: Chronic Special Needs Plan Improves Care for Diabetic Members

Unique Model of Care Reduces Hospitalizations and Readmissions

BALTIMORE, Jan. 10, 2012 /PRNewswire/ -- Care for some of Medicare's most vulnerable beneficiaries with diabetes can be effectively managed by Medicare Advantage Chronic Special Needs Plans, according to a new study published in the January issue of Health Affairs.

The study, "Medicare Advantage Chronic Special Needs Plan Boosted Primary Care, Reduced Hospital Use Among Diabetes Patients," demonstrates the positive impact of XLHealth's Care Improvement Plus special needs plan and its unique model of care on Medicare members diagnosed with diabetes.

In comparing 36,000 Care Improvement Plus members with diabetes to a similar population enrolled in traditional Medicare, the study found that special needs plan members experienced increased primary care and reduced rates of hospitalization and hospital readmissions. The study's results indicate that incorporating additional services aimed at the care of individuals with chronic diseases could result in lower Medicare spending, and may improve the quality of life for beneficiaries with diabetes.

Notably, the study results revealed that Care Improvement Plus' integration of additional services, such as in-home preventive health visits which include foot exams, social needs assessments, and medication reviews, drastically reduced hospital readmission rates. Specifically, data showed that Care Improvement Plus services helped to reduce rates among special needs plan enrollees in the study sample by as much as 40 percent.

Another significant finding of the study concerned the plan's ability to reduce hospitalizations and readmissions for non-white members at rates greater than their white counterparts, suggesting that the plan's model is effective in addressing ethnic and racial disparities in health care.

"The increases in primary care and reductions in hospital care for the non-white population narrowed the gap in utilization rates between racial groups when compared with the fee-for-service population where the gap was more pronounced," says Robb Cohen, Chief Government Affairs Officer for XLHealth Corporation and a co-author of the study. "Our results suggest that by providing care coordination services to groups impacted by health disparities, it is possible to improve quality and reduce costs to levels closer to less disadvantaged populations."

"The current fee-for-service system does not account for the increased attention required for chronically ill individuals -- for this reason, they are a significant driver of Medicare spending, requiring frequent trips to the hospital," continues Cohen. "This study affirms our belief that the best way to manage the care of these individuals and reduce their health care costs is to provide an integrated approach which identifies gaps in care upfront, and promotes preventive health care through frequent, direct contact."

To access a copy of the full study article, "Medicare Advantage Chronic Special Needs Plan Diabetes Program Reduced Hospitalizations and Readmissions," please visit

About XLHealth Corporation
XLHealth Corporation ( is the owner and operator of Care Improvement Plus (, 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 including care management support.

SOURCE XLHealth Corporation