Senior Whole Health's Integrated Care Management Successfully Addresses Medicaid/Medicare Budget Challenges, Captures Attention at Congressional Briefings Held With Special Needs Plan Alliance (SNP)
Posted on: Tuesday, 27 February 2007, 12:01 CST
Amid sobering news of proposed deep cuts to Medicaid and Medicare budgets, Senior Whole Health (SWH) cites its intense integrated care management strategy as a fiscally sound approach that can be replicated nationwide to deliver quality services at reasonable costs. SWH, a leading health care plan founded in 2003 that provides intensive, integrated case management services to seniors 65 and older, participated at Congressional briefings held in conjunction with the recent Winter Meeting of the Special Needs Plan Alliance (SNP) held in Washington, DC.
"The SNP Alliance is committed to keeping the bar high for SNPs and establishing standards that will result in the targeting of high-risk beneficiaries and the development of innovative specialty programs such as those implemented by Senior Whole Health and other legacy specialty plans," said Richard Bringewatt, NHPG President and Chair of the SNP Alliance.
John Baackes, CEO of Senior Whole Health, which operates plans for dual eligible beneficiaries in Massachusetts, Connecticut and New York stated, "Our positive experience with beneficiaries documents the value of having a designated Nurse Care Manager who provides professional and personalized dedication to the coordination of care. This designated contact point not only enhances the level of care for the patient but also relieves the pressures on caregivers, family members and others to identify appropriate health services, arrange and monitor care. Results can be measured in better healthcare outcomes, emergency room avoidance, and more effective allocation of resources to successfully tackle the current fragmentation of care delivery."
Baackes shared his concerns for impending program cuts and emphasized the strength of combining an insurance-health plan with care management services. SWH provides a bridge between intensive medical services through total home care that relies upon strong working relationships with other local agencies.
The SNP Alliance founded by the National Health Care Policy Group (NHPG), (www.nhpg.org), is a national leadership organization for specialty health care plans and programs that is primarily concerned about improving total quality and cost performance for high-risk beneficiaries.
Members of the SNP Alliance work together to improve federal policy in support of fair and equitable payment for high-risk beneficiaries, integrating Medicare and Medicaid funding, administration and care delivery for dually eligible beneficiaries, and implementing quality measures that evaluate plan performance in relation to the unique needs of beneficiaries with complex chronic conditions.
The SNP Alliance's commitment to demonstrating added value was underscored at the Winter Meeting by the group's adoption of quality standards developed by the SNP Alliance Medical Director Leadership Group as criteria for current and new members. A recommendation to require reporting on these standards was also presented as part of the Alliance's proposed legislation to extend SNP statutory authority.
"America must maintain its commitment to the healthcare needs of frail elderly patients but with an eye on accountability and performance," says Baackes. "Senior Whole Health assures our nation's low-income elderly residents that they have access to more than just health insurance, with a care management program that keeps each person as healthy and independent as possible. This formula works, with proven results that may mitigate the need for program cuts."
The SNP Alliance believes that:
Specialized, prepaid, community-based, integrated care is the preferred approach to serving high-risk Medicare and Medicaid beneficiaries.
National health policy leaders and SNP executives cannot afford to conduct business as usual.
Long-term SNP success is dependent upon further improvements in payment methods, integrating Medicare and Medicaid, and advancing performance evaluation.
System transformation requires dedicated, collaborative, proactive national leadership.
About Senior Whole Health
Founded in 2003, Senior Whole Health offers 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 65 or older 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
Related Articles
- RetireSafe Blasts AARP for Supporting Plan to Pay for Health Care on the Backs of Seniors
- General Dynamics Awarded $45 Million Task Order by the Centers for Medicare & Medicaid Services
- Coventry Health Care/HealthAmerica Expands Coverage to Offer Medicare Advantage Plans to Beneficiaries in 12 Additional Pennsylvania Counties
- Coventry Health Care/Carelink Expands Coverage to Offer Medicare Advantage Plans to Beneficiaries in 28 Additional West Virginia Counties
- Centers for Medicare & Medicaid Services Selects Cerner to Participate in Quality Reporting Initiative
- Thomson Healthcare Selected By Centers for Medicare & Medicaid Services to Help Detect Medicaid Overpayments
- Highmark Medicare Services Awarded New Contract From Centers for Medicare & Medicaid Services
- Centers for Medicare & Medicaid Services' Lambert Van Der Walde to Address Senior Healthcare Executives Meeting in Chicago
- TriZetto Personal Health Record Technology To Be Used in Six-Month Feasibility Test for the Centers for Medicare & Medicaid Services
- Odyssey HealthCare Comments on Centers for Medicare & Medicaid Services Hospice Cap Calculation
 |
 |
User Comments (0)
RSS Feeds