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WellPoint, Emory partner to create new senior care model


By Rachel Landen
Posted: March 19, 2014 - 3:45 pm ET
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WellPoint is expanding its reach into healthcare with an announcement Wednesday 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 close to 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.

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“We have been impressed with CareMore's success in improving the health of senior members through their highly coordinated care model that leverages technology, early intervention and a personal touch,” Emory Healthcare Network President and Chief Quality Officer Dr. Richard Gitomer said in a news release. “With our CareMore collaboration, we are eager to deliver those benefits to our patients as well.”

With 200 provider locations and six hospitals in Georgia, Emory Healthcare Network is the first 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, $20.75 million grant from the CMS Center for Medicare & Medicaid Innovation to help 90 primary-care practices create an improved, lower-cost care delivery network.

If negotiations surrounding this latest joint venture between Emory Healthcare Network and CareMore are successful, organization officials expect the new model to be in place early next year.

“It's a win-win collaboration for all because we will help in improving the quality of life for our patients, while lowering healthcare costs,” Emory Healthcare President and CEO John Fox said in the release.

In January,Emory Healthcare announced that it had signed an agreement with WellPoint's Blue Cross and Blue Shield of Georgia to form an accountable care organization designed to coordinate care and align resources for improved outcomes.

Follow Rachel Landen on Twitter: @MHrlanden


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