Health Insurers Outline Medicare Expansion Plans

Margaret Dick Tocknell, for HealthLeaders Media , May 30, 2012

WellPoint says its CareMore strategy is taking shape. While the June 2011 acquisition added about 54,000 new Medicare Advantage members to WellPoint’s rolls, the real focus was CareMore’s healthcare clinics in Arizona, California, and Nevada. The clinics, which are staffed with physicians and other healthcare professionals, specialize in delivering care coordination and intensive treatment to the chronically ill.

The clinics are critical to WellPoint’s participation in Los Angeles County's dual-eligible demonstration project. The insurer will subcontract with L.A. Care beginning in 2013 and the CareMore delivery model will mean that WellPoint will be more able to manage the cost of specialized care for this fragile population.

WellPoint operates 29 CareMore facilities, which it now calls neighborhood care centers, and plans to open at least 12 more in 2012. Seven of the centers will be located in expansion states, which will be new to the CareMore model, but familiar WellPoint markets. WellPoint officials declined to identify the expansion states.

WellPoint has introduced several hospital contracting initiatives, such as value-based contracting, which it credits (at least in part) with lower increases in unit cost trends in 2012. The insurer will begin introducing to select markets in third-quarter 2012 value-based contracting to its primary care physician network. The goal is to expand value-based contracting across its entire primary care network by the end of 2014.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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