CareMore

Multistate

CareMore, a Medicare Advantage health plan, was an early adopter of the idea that targeting high-risk patients could improve outcomes and reduce costs. The plan uses capitated Medicaid payments to pay for transportation, patient education and a multi-disciplinary care team at one of the plan's Care Centers. CareMore operates in seven states (California, Nevada, Arizona, Iowa, Tennessee, Georgia and Virginia) and covers 130,000 lives. The plan partners with its network of primary care physicians in order to identify high-risk patients who are then referred for treatment at one of the integrated Care Centers. The team is designed to provide high-touch care before, during and after visits. To make the program cost-effective, nurses and non-physician staff are relied on to perform a good deal of care.

Partner Organizations

• Medicare and Dual-Eligible Providers in the plan's network across 7 states
• Amerigroup
• Emory Health System

Target Population

Medicare beneficiaries and dual-eligibles with high-cost, high-risk conditions

Care Team

Nurse practitioners, medical assistants, physicians

Timeframe

2010 - present

Results/ Studies

N/A

Funding

Medicare per-member per-month payments                                                   

Resources

CareMore main website

Profile by the Commonwealth Fund (2017)