CarePlus
Complementary care reducing cost and hospitalization
CarePlus, INSPIRIS' flagship program, provides health plans with a complementary system of clinical care that can reduce cost and acute-care hospitalization of Medicare members who live in nursing homes. Typical disease management and behavior modification techniques are largely ineffective because of the high prevalence of dementia in this population. CarePlus, therefore, is a unique model that integrates INSPIRIS medical and clinical personnel with a health plan's resources and medical network.
Care is delivered bedside where patients can remain in a stable, familiar setting. Led by a registered nurse practitioner, the INSPIRIS clinical team uses predictive modeling and stratification methods to assess patients and create individual treatment plans that address medical diagnoses, general health status and expressed advance directives.
INSPIRIS' clinical teams promptly implement treatment plans and deliver care in the long-term care setting. Their prompt intervention and added focus on clear, comprehensive communication among the providers, the member, the family members and the health plan, alleviate inappropriate medical intervention and unnecessary emergency care and hospitalization.
A Medicare Advantage member living in a long-term care facility typically costs a plan 1.5 times its premium revenues. By implementing INSPIRIS' CarePlus program, a plan can reduce these costs by more than 50 percent, and significantly increase quality and satisfaction outcomes.
Selected Outcomes
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