Innovating for healthier people

With millions of Baby Boomers aging into Medicare over the next several decades, there is a great need to change how we meet the health care needs of seniors. CareMore, the newest addition to WellPoint’s family of companies, reinvented how to improve senior health and their lives overall.

The first thing CareMore does is listen—to the patient, to their family, to all of their physicians and caregivers. Then we develop an individual plan around the unique circumstances that every patient brings. The cornerstone of our model is the CareMore Care Center, which provides everything from rides to appointments and mental health screenings to regular toe-nail clippings and help picking up prescriptions.

Beyond the Care Centers, CareMore coordinates our members through inpatient, outpatient, and skilled nursing care. This non-traditional approach prevents costly complications and helps seniors live more healthy and rewarding lives.

Compared to the national average, CareMore’s hospitalization rates are 24 percent lower, hospital stays are 38 percent shorter, and amputation rates among diabetics are 60 percent lower.

We know strong doctor-patient relationships can prevent illness and improve patient health. So we are significantly increasing our support of primary care physicians and the health of their patients. This innovative approach builds on the success of our patient centered medical home (PCMH) programs across the country, which increase payments to primary care physicians who commit to expanding access to their patients, coordinating their care, and being accountable for their overall health and quality of care.

Over the first two years, our PCMH program in Colorado decreased hospital admissions by 18 percent and reduced emergency room visits by 15 percent.

Our similar accountable care organization (ACO) partnership with Dartmouth-Hitchcock medical center reduced hospital admissions and emergency room visits, and lowered medical costs even more than expected.

These programs demonstrate that by rewarding doctors for improving members’ health rather than simply providing more services, we can help improve the way health care is delivered, leading to better coordination among care teams and better outcomes for members.

WellPoint’s mission is to improve the lives of the people we serve and the health of our communities. To hold ourselves accountable to achieving it, we created the Member Health Index. The index measures 32 key health indicators such as cancer screenings, vaccination rates, preventable hospital admissions and emergency room visits.

The Index helps us understand whether our health plan members are getting the right preventive care—like flu vaccines, colonoscopies and mammograms—and whether they’re at risk of avoidable complications from heart disease, diabetes, and other chronic conditions. This information helps us identify how we can use targeted educational outreach and other tools to further improve member health. As a result, we boosted the number of members who received colorectal cancer screening tests by more than 5 percent in 2011.

We are proud to be the first health benefits company to establish such an index. More importantly, we are proud that the Member Health Index has improved in each of the five years since its creation.