Coventry and Medco Partner to Develop Personalized Care Program to Reduce Hospitalizations among the Medicare Population
BETHESDA, Md. and FRANKLIN LAKES, N.J., Dec. 1 /PRNewswire-FirstCall/ -- One of the greatest financial tolls on the nation's health care system is the cost of hospitalizations for the elderly, with Medicare spending reaching $196.2 billion in 2007. To develop a care model that could significantly reduce hospitalizations and their related costs for the Medicare population, Coventry Health Care, Inc. (NYSE: CVH) and Medco Health Solutions, Inc. (NYSE: MHS) today announced the launch of the Coventry Outcomes Study of Seniors (COSS).
COSS is the first comparative effectiveness study designed to identify seniors most at risk for hospitalization and reduce such risk by using a coordinated health care team that works directly with patients through regular home visits and phone communications.
The care teams - consisting of a Coventry nurse case manager, social worker and medical director, and a Medco specialist pharmacist - will work in tandem with the patient's primary care physician and outside care agencies to identify and address factors that leave patients in poorer health, including improper diet, inadequate management of health conditions and safety issues in the home.
"Clearly a different approach is needed to address the factors that lead to hospitalizations in high-risk patient populations," said Allen F. Wise, Coventry Health Care CEO. "We are hopeful that a more hands-on and integrated care model will prove to be far more effective in addressing the issues that affect patient health and preventing serious medical problems that require hospitalization."
The 12-month, randomized study will involve members enrolled in the Coventry Advantra Medicare Advantage Plan and will compare high-risk members who are receiving coordinated care from an outreach team to a control group receiving covered services through their health plan. Patients in the study group will be visited regularly by the care team as well as contacted via telephone to assess their health situation, address specific issues and provide information and counseling. The services will be supported by an integrated data system with the patient's medical and pharmacy records to help identify any existing medication safety risks and gaps in care.
Seniors ages 65 and older have greater risks for chronic conditions including diabetes, heart disease and pulmonary disease, and have an increased risk for hospitalization from complications of these conditions. For patients over age 65 the rate of hospitalization from heart failure has increased by 131 percent from 1980 and 2006. In addition, nearly one-third of seniors have been diagnosed with diabetes and it is estimated that an additional 30 percent are pre-diabetic.
"While hospitalization rates for those under 65 have steadily decreased in recent years, the exact opposite holds true for the Medicare population and many of these patients return to the hospital within a month," said Medco Chairman and CEO David B. Snow, Jr. "The hypothesis driving this study is that providing direct and regular contact between the patient and the care team will motivate and help patients to better manage their chronic conditions, thus keeping seniors healthier and out of the hospital which will also help lower Medicare spending."
The COSS study will include approximately 2,150 patients living in St. Louis and Kansas City, MO, who are enrolled in Coventry's Advantra Medicare Advantage Plan and have been identified as having several risk factors for hospitalization. Enrollment in the study begins in late 2009 and patients will be monitored for one year after enrollment.
About Coventry Health Care
Coventry Health Care (www.coventryhealthcare.com) is a diversified national managed healthcare company based in Bethesda, Maryland, operating health plans, insurance companies, network rental and workers' compensation services companies. Coventry provides a full range of risk and fee-based managed care products and services to a broad cross section of individuals, employer and government-funded groups, government agencies, and other insurance carriers and administrators.
Medco Health Solutions, Inc. (NYSE: MHS) is pioneering the world's most advanced pharmacy® and its clinical research and innovations are part of Medco making medicine smarterTM for more than 60 million members.
With more than 20,000 employees dedicated to improving patient health and reducing costs for a wide range of public and private sector clients, and 2008 revenue exceeding $51 billion, Medco ranks 45th on the Fortune 500 list and is named among the world's most innovative, most admired and most trustworthy companies.
For more information, go to http://www.medcohealth.com.
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