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Evercare(R) Reaches 100,000 Enrollees Across 35 States; Focus on Integrating Care to Meet Needs of Most Vulnerable Patients Proves Winning Model in Attracting Enrollees and Spurring Innovation

Posted on: Monday, 26 June 2006, 15:00 CDT

Evercare, a leading provider of health plans for frail elderly, disabled and chronically ill individuals in the United States, today announced that it has surpassed 100,000 enrollees across 35 states. For almost 20 years, Evercare has been dedicated to enhancing the quality of life and optimizing the well-being of its served populations, whether in the community or in nursing homes, through a variety of Medicare, Medicaid and private-pay long-term care plans.

Evercare CEO, John Mach, M.D. said, "Our growth has been driven largely by our ability to meet the needs of people who require a holistic approach to their health that emphasizes coordination of multiple treatments, health maintenance and preventative care. Our focus is on keeping them healthier, avoiding trips to the hospital, and enabling them to function and live more independently. Evercare's growth was also boosted by the advent of Special Needs Plans, which Congress and CMS created for better coordinated care of vulnerable populations."

Evercare was founded in 1987 by two Minnesota nurse practitioners who sought to reduce fragmentation in geriatric care by creating a model of care that emphasized collaborative relationships with their patients, caregivers and health care professionals. Their philosophy and shared passion laid the foundation for the nation's largest single care coordination program for the frail elderly, disabled and chronically ill. The Company received Medicare demonstration status for its plans in 1995 and worked with state long-term care Medicaid systems to develop programs that integrate and coordinate medical, home and community-based services.

Chronically ill individuals with five or more medical conditions made up only 20 percent of all Medicare beneficiaries in 2004, but accounted for over two-thirds of the program's $302 billion in costs. In any single year, such beneficiaries are likely to fill up to 53 prescriptions, visit emergency rooms a dozen times or more, and require hospitalization at least five times. The traditional Medicare and Medicaid fee-for-service systems were structured primarily to provide acute care, not to meet the needs of the chronically ill through a coordinated approach. This fragmentation of care can lead to poor health outcomes that are draining for patients and physicians alike and are unnecessarily costly. In fact, according to a recent study that examined costs associated with caring for chronically ill seniors enrolled in Medicare between 2000 and 2003, $40 billion, or nearly one third of what is spent for their care, is potentially unnecessary. (Dartmouth Atlas Project, 2006)

The Evercare Approach: Meeting the Needs of Each Enrollee

Evercare integrates medical, health, and social support services to enhance enrollees' access to health care and their quality of life. Evercare enrollees are served by care managers or nurse practitioners who develop and manage customized care programs. They coordinate multiple services; facilitate better communication between physicians, institutions, patients and their families; and help ensure effective integration of treatments.

In the community, Evercare plans provide a care manager who works with the family, the primary care physician, other health care professionals and aging organizations to help ensure the best use of health care and community resources. In the nursing home, Evercare plans increase preventive care through a collaborative approach involving an Evercare nurse practitioner and contracted nursing facility staff and teams of health care professionals. In most cases, Evercare plans provide enrollees with more services and coverage than regular Medicare or Medicaid alone.

According to American Association of Homes and Services for the Aging (AAHSA) President and CEO, Larry Minnix, the Evercare approach is an excellent example of a pioneering solution of coordinated, effective health care delivery.

"Under regular Medicaid and Medicare, health service delivery is fragmented, making it difficult for the aging, chronically ill and disabled to receive the care they need," says Minnix. "Bringing together separate medical, health-related and social services offered under these programs results in better health outcomes, more satisfied enrollees, and lower overall costs for everyone."

Evercare also has earned consistently high satisfaction rates among enrollees and their responsible parties even while expanding its reach. Evercare's plan for nursing home residents achieved 97 percent family satisfaction in a 2005 survey of responsible parties, and has been consistently over 95 percent for the last seven years. In a 2005 survey of enrollees in Evercare's community-based plans, on average, 91 percent of enrollees and their responsible parties were satisfied and 95 percent intended to continue their membership with Evercare. (Market Strategies, 2005)

Providing High-Quality, Cost-Effective Care to Vulnerable Populations

Evercare has grown from 64,731 enrollees in December 2003 to more than 100,000 enrollees today by reaching out to individuals in danger of being overlooked by the health care system. Community enrollment totals nearly 70,000; and more than 30,000 nursing home patients are currently benefiting from Evercare.

Offerings include Special Needs Plans for those in nursing homes and for people with Medicare and Medicaid ("Dual Eligibles") as well as Medicare Advantage plans for people with Medicare only living in the community; and integrated Medicare-Medicaid plans offered through states' Medicaid programs. Evercare nursing home and community Special Needs Plans include Medicare "Part D" prescription drug coverage. Evercare(TM) Palliative and Hospice services support patients and families coping with advanced, life-limiting illnesses. Evercare also offers Evercare Connections -- Evercare(TM) Solutions for Caregivers, a service that helps people caring for an aging relative or friend navigate the health care system and obtain the appropriate care and services. Additional offerings include Evercare's Health Plan for People on Dialysis.

Research demonstrates that Evercare's approach to care results in greater access to medical and non-medical services, better health outcomes, and lower cost to the government:

-- Health professional teamwork and continuity of care have been shown to help prevent some problems before they become serious - reducing hospitalizations for nursing home residents by 45 percent and emergency room visits by 50 percent. (Journal of American Geriatrics, 2003.)

-- Evercare nursing home patients were seen more by their physicians than their peers enrolled in other plans. While they were also hospitalized half as often as their counterparts, Evercare enrollees were more satisfied that they would be hospitalized when necessary. (CMS Outcome Study, 2002.)

-- Through the Texas STAR+PLUS program, Evercare helped reduce hospitalizations by 22 percent and ER visits by 38 percent, and 90 percent of enrollees said they were satisfied with their care coordinators. Evercare also helped the state government save $123 million in Harris County over two years. (Texas A&M University, 2002.)

-- As of June 2003, over 60% of elderly and physically disabled individuals enrolled in the Arizona Long Term Care System programs (like Evercare) were able to live independently in their communities, avoiding nursing homes and compared to 5% at the inception of the program in 1989. (State of Arizona Claims Data, 2003)

-- In Florida, vulnerable populations enrolled in Nursing Home Diversion programs, like Evercare's community plan, were nine times less likely to enter nursing homes for an extended stay. (Florida Office of Program Policy Analysis & Government Accountability, 2006)

A Proven Leader in Coordinated Care

Evercare measures success by the quality of care delivered to its 100,000 enrollees. The largest business of its kind, Evercare has been internationally recognized for its innovation and success in improving enrollees' health and managing care costs.

Evercare served as a key precedent for the Special Needs Plans (SNP) created under the Medicare Modernization Act of 2003. A leader in the field, Evercare has more SNPs than any other health plan provider. Evercare has contracted with more than 1,000 nursing facilities and is a major employer of nurse practitioners and nurse care managers.

-- In 1999, Evercare received the American Society of Aging Award for Innovation and Quality.

-- In 2002, BusinessWeek cited Evercare's use of leading-edge technology in nursing homes as a key UnitedHealth Group innovation.

-- In 2002, Britain's National Health Service (NHS) awarded Evercare a contract to assist with designing and implementing systemwide reforms to promote better patient outcomes and savings through greater care integration.

"As the baby boomer generation ages, Evercare is poised for still greater achievement, both by helping improve care for more people in states we currently serve and by expanding to new states," said Dr. Mach. "There also are near-term avenues of growth as the integration of UnitedHealth Group and PacifiCare Health Systems continues and our parent company grows and evolves to serve a changing marketplace even better."

A Stronger Online Presence Through www.Evercarehealthplans.com

To serve the growing Evercare community better, Evercare recently launched its newly designed Web site, www.evercarehealthplans.com. Enrollees, prospective members, health care professionals, state and federal government officials and community-based organizations will all have access to useful information and tools on the site. A product finder will help current and prospective enrollees find the Evercare offerings that best serve their needs. Health care professionals can access the up-to-date forms and contact information they require, and payers can find everything they need to know about partnering with Evercare. In future releases of the Web site, Web site visitors will be able to enroll online and assess their health risks. The Web site was developed based on extensive consumer input and will allow Evercare to build, maintain and enhance strong relationships with all its stakeholders as it continues to grow.

About Evercare

Evercare coordinates health care and well-being services for the frail elderly, chronically ill, and disabled in the home, the community and skilled nursing facilities. Started in 1987, Evercare today serves more than 100,000 people nationwide through a variety of Medicaid, Medicare, and private-pay health plans. Evercare is part of Ovations, a division of UnitedHealth Group (NYSE:UNH) dedicated to the health care needs of over-50 Americans. For more information about Evercare, call 1-866-772-0859 (TTY 1-888-685-8480) or visit www.evercarehealthplans.com.

About UnitedHealth Group

UnitedHealth Group (www.unitedhealthgroup.com) is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, Uniprise, Specialized Care Services and Ingenix. Through its family of businesses, UnitedHealth Group serves approximately 70 million individuals nationwide.

Forward-Looking Statements

This news release may contain statements, estimates or projections that constitute "forward-looking" statements as defined under U.S. federal securities laws. Generally the words "believe,""expect,""intend,""estimate,""anticipate,""project,""will" and similar expressions identify forward-looking statements, which generally are not historical in nature. These statements may contain information about financial prospects, economic conditions, trends and unknown certainties. We caution that actual results could differ materially from those that management expects, depending on the outcome of certain factors. These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed in the forward-looking statements. Some factors that could cause results to differ materially from the forward-looking statements include: increases in health care costs that are higher than we anticipated in establishing our premium rates, including increased consumption of or costs of medical services; heightened competition as a result of new entrants into our market, and consolidation of health care companies and suppliers; events that may negatively affect our contract with AARP; uncertainties regarding changes in Medicare, including coordination of information systems and accuracy of certain assumptions; funding risks with respect to revenue received from Medicare and Medicaid programs; increases in costs and other liabilities associated with increased litigation, legislative activity and government regulation and review of our industry; potential consequences surrounding findings of our ongoing internal investigation, investigation by a committee of our independent directors and informal SEC inquiry into our stock option granting practices, as well as a subpoena from the office of the U.S. Attorney for the Southern District of New York requesting documents relating to stock option grants since 1999 and a request from the Internal Revenue Service for documents relating to the compensation of certain executive officers; uncertainty of results of pending civil litigation relating to our stock option granting practices; our ability to execute contracts on competitive terms with physicians, hospitals and other service providers; regulatory and other risks associated with the pharmacy benefits management industry; failure to maintain effective and efficient information systems, which could result in the loss of existing customers, difficulties in attracting new customers, difficulties in determining medical costs estimates and appropriate pricing, customer and physician and health care provider disputes, regulatory violations, increases in operating costs, or other adverse consequences; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and intangible assets recorded for businesses that we acquire; potential noncompliance by our business associates with patient privacy data; misappropriation of our proprietary technology; and anticipated benefits of acquiring PacifiCare may not be realized. This list of important factors is not intended to be exhaustive. A further list and description of some of these risks and uncertainties can be found in our reports filed with the Securities and Exchange Commission from time to time, including our annual reports on Form 10-K and quarterly reports on Form 10-Q. Any or all forward-looking statements we make may turn out to be wrong. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made. Except to the extent otherwise required by federal securities laws, we do not undertake to publicly update or revise any forward-looking statements.

Source: Business Wire

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