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Senior Whole Health Expands Medicare Advantage Special Needs Plan Coverage Area to Include Fairfield County, Conn.

Posted on: Tuesday, 9 October 2007, 15:00 CDT

Senior Whole Health, a Medicare Advantage Special Needs Plan (SNP) serving Medicare/ Medicaid beneficiaries in New Haven, Hartford and Middlesex counties, today announced that it will extend its coverage area to include Connecticut's Fairfield County, enrolling members beginning January 2008. Senior Whole Health also serves 50 percent of participating dual eligible beneficiaries in Massachusetts and qualified individuals in New York, spanning Albany, Dutchess, Saratoga, Schenectady, Rensselaer, and Ulster Counties.

"We have been working hard to ensure that Senior Whole Health's integrated case management services are available to as many people as possible in Connecticut," says Carissa Neubig, executive director of Senior Whole Health (SWH) in Connecticut, pointing to the plan's distinctive coordination of comprehensive services including preventive, primary, acute and specialty medical care, behavioral health, extended care, home care, community-based services and pharmacy. "Our entrance into Fairfield County enables us to further serve this state's neediest population with the same success we have had in other service areas."

Currently, there are over five million dual eligible beneficiaries in the United States, with 60,000 living in Connecticut. In every state, Medicaid costs are increasing faster than the rate of inflation, largely because an aging population of poor people consume an enormous amount of resources with end-of-life medical care and long-term nursing home care. At the heart of the issue is the fact that 15 percent of the people who qualify for Medicaid are over 65, yet they use 45 percent of all the Medicaid dollars.

"Senior Whole Health represents the model for how managed care is supposed to work, facilitating coordinated care to the frail elderly, chronically ill and disabled individuals," says Neubig. "We look forward to working with a collaborative team of physicians, hospitals, area agencies, elder care facilities and government officials to meet the needs of this diverse population."

SWH's SNP model streamlines Medicare and Medicaid benefits, simplifying benefits and case management as part of providing coordinated care planning to beneficiaries. A nurse case manager and a support staff of community resource coordinators are responsible for overseeing care for members across all locations and levels of care.

"Members, their primary care doctors, and families love the attention coordinated care plans bring to the member," adds Neubig. "By keeping people well at home and avoiding institutional care and frequent hospital stays, this model can reduce medical inflation and improve the quality of life of the patient. In three years of operating this type of plan, Senior Whole Health has had extremely high member retention, with less than one half of one percent voluntary disenrollment."

Neubig attributes this successful track record to the coordination of three well-intended programs into one comprehensive and comprehensible program that focuses on the patient.

"We look forward to bringing this proven approach to Fairfield County and to continued partnerships with community healthcare leaders that result in enhanced services for all members."

About Senior Whole Health

Founded in 2003 and headquartered in Cambridge, MA, Senior Whole Health is a privately-held company offering intensive, integrated case management services for Medicare/Medicaid dual eligibles and Medicare Part D. Senior Whole Health's Special Needs Plans (SNPs) plans are designed for people who are Medicare & Medicaid eligible and live in the Senior Whole Health service areas. SNPs serve the chronically ill, the institutionalized and Medicare/Medicaid dual eligibles. Visit www.seniorwholehealth.com or call 1.888.749.7268.

Source: Business Wire

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