By Katie Sullivan
To solidify itself as a niche care facility, Jason Barker, president of Medicare health plans for CareMore, a WellPoint subsidiary based in Cerritos,California, said his organization decided to specialize and focus solely on older, more frail patients. The system operates in California, Nevada, Arizona and Virginia.
Barker said his group coordinates care to improve quality and lower costs. The system runs on the idea that primary care is an outbound, not inbound activity, where doctors work together on preventive care, Barker said during his presentation this week at the American Hospital Association's annual membership in the District of Columbia.
"The essentials of our care model have to do with predictive modeling and earlier intervention," Barker said, along with chronic care management and acute care management within a patient-centered care model. This allows the care team to aggressively treat and monitor diabetes, congestive heart failure and end stage renal disease.
For example, if a patient gains more than three pounds overnight or one pound day for three days, he or she must visit with a clinician within 24 hours. This model helped drop length of stay 38 percent and drop the hospitalization rate 24 percent below Medicare average, according to Barker. In addition, he said amputation rates related to diabetes are 60 percent below the national average.