It is estimated that only 20 percent of our health is related to factors we associate with traditional medicine: Doctors, clinics, hospitals, etc.
The other 80 percent are factors like food, housing, transportation and social support systems. These factors, known as “social determinants of health,” are addressed by a holistic approach known as “whole-person health.”
CareMore is an innovator in whole-person health. While health plans typically typically have a narrow medical focus, CareMore views health in a broader context of physical, behavioral and social factors. Accordingly, our care model includes home visits and an assessment of home environment including healthy food, sleep, transportation.
The CareMore treatment model is data-driven and based on industry-leading protocols. But care is personalized, with treatment plans customized for the patient’s unique situation and medical needs. Our deep relationships with our patients lead to better clinical outcomes and high patient satisfaction, while lowering the cost of care.
We understand our patients, because we take time during appointments to listen to their personal concerns, challenges and goals. While appointments in a managed care plan often are squeezed into 7 to 12 minutes, a typical appointment at a CareMore Care Center can last 45 minutes.
The personal connection with our CareMore clinicians leads to high member satisfaction and engagement in their treatment plan. Members who are engaged in their treatment are more likely to maintain healthy behaviors, stay on their medications and adhere to a treatment regimen.
These members have deeper loyalty to their CareMore plan and are more likely to re-enroll. And as loyal members re-enroll annually, CareMore realizes greater efficiencies in patient management and cost savings, as well as superior clinical outcomes.
CareMore was an early advocate of value-based care. We have a long and successful history of full-risk capitation, risk sharing, aligned incentives, and accountability for cost and outcomes. Accurate risk assessment is achieved early through automated claims review, clinical referral and Healthy Start visit. We manage risk through ongoing patient monitoring, care management, clinical review and data capture. Aligned incentives ensure the clinical team is working toward shared goals of patient satisfaction, cost effectiveness and outcomes.
CareMore Anytime is the “first call” for members seeking immediate help with a health issue. The service is available 24/7 and staffed by experienced clinicians. Clinicians can access physician-approved protocols and health information. They also draw on practical experience from their roles in clinics and hospitals. A call to CareMore Anytime often quickly addresses a member’s concern, avoiding an expensive trip to the emergency room.
The CareMore approach controls costs by providing care in the right place, at the right time, in the right setting. Our care model allows flexibility to treat patients in the least restrictive setting consistent with medical needs. Case managers ensure continuity of care and efficient use of resources as patients move across treatment settings. Our goal is to return patients to the most comfortable environment, often their home, where they can enjoy normal activities and quality of life.
Care is personal, and so are we
CareMore’s unified EMR system integrates patient admission and discharge, care and utilization management, treatment planning and decision support. We track patient progress from initial assessment through every step of their care journey. Clinicians access a unified patient record, ensuring that care is well coordinated across visits, patient concerns are documented, and medical decisions align with the treatment plan.
Care management for our patients is personalized and proactive. We use claims data and clinical referrals to identify members who would benefit from CareMore’s extra level of care. Following their Healthy Start assessment, patients are stratified into risk segments for effective management. Nurses initiate outreach by calling the member and notifying the primary care physician. The care planning process includes short- and long-term goals, medication review, diet education, referrals to community and financial resources, and transitions between care settings.