Wel­lPoint, Emory part­ner to cre­ate se­nior-care model

Modern Healthcare - - REGIONAL NEWS - —Rachel Lan­den

Wel­lPoint is ex­pand­ing its reach into health­care with an an­nounce­ment that the in­surer’s sub­sidiary, CareMore Health Sys­tem, will part­ner with the Emory Health­care Net­work in At­lanta on a new care model for se­niors.

Un­der the agree­ment, Emory Health­care Net­work plans to im­ple­ment CareMore’s clin­i­cal care model for re­duc­ing costs and in­creas­ing qual­ity for Medi­care Ad­van­tage pa­tients. The col­lab­o­ra­tion will fo­cus on value-based re­im­burse­ment and risk-based pay­ment ar­range­ments, while Emory adds more com­pre­hen­sive care cen­ters sim­i­lar to CareMore’s fa­cil­i­ties.

CareMore al­ready serves nearly 70,000 Medi­care mem­bers in Ari­zona, Cal­i­for­nia and Ne­vada through its health plans, com­pre­hen­sive care cen­ters and spe­cial­ized health­care pro­grams for fall preven­tion and di­a­betes mon­i­tor­ing. With 200 provider lo­ca­tions and six hos­pi­tals in Ge­or­gia, Emory Health­care Net­work is the first health­care provider or­ga­ni­za­tion in the area to col­lab­o­rate with CareMore on this kind of ad­vis­ing ini­tia­tive, though it isn’t a new con­cept for some or­ga­ni­za­tions.

The Amer­i­can Academy of Fam­ily Physi­cians has been in the con­sult­ing arena since 2005 when it launched

Trans­forMED, its sub­sidiary that works with pri­mary-care prac­tices to adopt the med­i­cal home model. Last year, Trans­forMED an­nounced it had re­ceived a three-year, $20.8 mil­lion grant from the CMS’ Cen­ter for Medi­care & Med­i­caid In­no­va­tion to help 90 pri­mary-care prac­tices cre­ate an im­proved, lower-cost care de­liv­ery net­work.

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