- 160,000 South Carolinians Qualify for New Disease Management Focused Plan
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COLUMBIA, S.C., Oct. 24 /PRNewswire/ -- Approximately 160,000 Medicare
beneficiaries in South Carolina are eligible to join Care Improvement Plus,
South Carolina's first health plan to focus exclusively on chronically ill
Medicare beneficiaries and their unique healthcare needs.
Care Improvement Plus has obtained formal approval from the Centers for
Medicare & Medicaid Services to offer a new type of Medicare Advantage
"Special Needs" Plan that provides all Medicare covered services, a
tailored Medicare Part D drug benefit, and disease management services to
Medicare beneficiaries in South Carolina with diabetes, heart failure,
chronic obstructive pulmonary disease (COPD), and/or end-stage renal
disease (ESRD).
"This is the first time a plan like this has been offered to South
Carolina's chronically ill seniors," Robb Cohen, vice president of
government affairs for XLHealth, parent company of Care Improvement Plus.
"While disease management-focused health plans are a new concept, our focus
on providing tools to help manage chronic conditions makes sense for this
population. Not only can our services help them ward off avoidable disease
complications such as amputation, blindness, stroke and heart attack, but
we also can help address the approaching Medicare fiscal crisis by reducing
the need for expensive treatments and hospitalizations."
A recent government forecast (http://www.ssa.gov/OACT/TRSUM) attributes
the approaching Medicare fiscal crisis to soaring healthcare costs, the
approaching retirement of 78 million baby boomers, and their increasing
demand for complex health services. In an effort to help improve care and
rein in costs, the Medicare Modernization Act of 2003 allows Medicare
Advantage organizations to offer Special Needs Plans to three groups of
Medicare beneficiaries: those with chronic illness, those residing in
nursing homes, and low-income individuals who qualify for both Medicare and
Medicaid. Care Improvement Plus was approved to offer a chronic illness
Special Needs Plan to residents of South Carolina.
"For seniors living with chronic illness, managing their conditions and
following their physician's directives can be confusing and challenging,"
said O. Marion Burton, M.D., Associate Dean for Clinical Affairs,
University of South Carolina School of Medicine, University Specialty
Clinics. "Health plans such as this, with increased health monitoring and
supportive disease management services, have the potential to improve
patient compliance with physician care plans and possibly prevent dangerous
complications."
Each plan member is assigned a Care Improvement Plus care team
comprising a dedicated local healthcare manager, local field nurse and
telephone coach nurse - all of whom work closely with the member's
physicians to coordinate services and help provide optimal care. Members
receive coverage that offers the advantages of traditional Medicare, plus
additional benefits, care coordination, and services as appropriate, such
as:
-- the ability to see any provider that accepts Medicare
-- $0 or no-cost premiums and co-pays
-- comprehensive prescription drug coverage under Medicare Part D - with a
formulary specifically designed for people with diabetes and other
chronic health conditions
-- expanded Medicare benefits including more comprehensive podiatry visits
-- nursing support in person or by telephone
-- medication monitoring and counseling
-- medication and appointment reminders
-- education on symptoms and early warning signs of complications
-- tools to help monitor and manage health, such as diabetic protective
shoes and/or blood pressure cuffs for those who qualify
-- free transportation services
Care Improvement Plus also supports participating physicians with a
variety of services designed to help them care for chronically ill
patients, such as: compensation for time spent on non-Medicare covered
services, an open-access model that doesn't require referrals, collection
of medical histories in advance of office visits, and easy-to-read reports
containing all of each patient's up-to-date information.
Care Improvement Plus is currently accepting enrollment applications
for coverage effective January 1, 2007. To join, individuals must live in
South Carolina, be eligible for Medicare, and have diabetes, heart failure,
COPD and/or ESRD. Those interested in learning more about the plan can call
(866) 651-1979 to speak with a plan representative or visit the plan's Web
site at http://www.careimprovementplus.com.
About Care Improvement Plus
Care Improvement Plus, a new health plan that focuses on the unique
healthcare needs of chronically ill Medicare beneficiaries, provides a
Medicare Advantage health plan and disease management services to Medicare
beneficiaries living with heart failure, diabetes, chronic obstructive
pulmonary disease and/or end-stage renal disease. Care Improvement Plus
also provides tailored Medicare Part D drug coverage, along with a variety
of services designed to support physicians' efforts to care for their
chronically ill patients. Care Improvement Plus has received Full
Accreditation for its patient and practitioner disease management program
from the National Committee for Quality Assurance (NCQA). The plan is
administered by Baltimore-based XLHealth, one of the nation's fastest
growing disease management companies. More information about XLHealth and
Care Improvement Plus can be found at http://www.careimprovementplus.com.
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