CareMore

CareMore operates neighborhood-based care centers that act as supplementary extensions of the patient's primary care physician offices. The goal of the Care Center is to provide a one-stop shop for care services, reducing travel time, likelihood of missing an appointment and duplication of efforts. Each Center provides a range of primary care medical services as well as podiatry, mental health services, diabetes management, wound management, hypertension management programs, and prevention services.[9] In 2016, CareMore announced a partnership with the ride-sharing application Lyft to provide free rides for patients to the Care Center and further increase accessibility.[10]

CareMore offers its patients a high-touch, proactive approach to chronic disease management designed to minimize the probability of an acute episode of care. After a comprehensive medical evaluation, patients with chronic conditions are enrolled in one of CareMore’s 14 different disease management programs. Once in a program, patients are seen periodically in a CareMore Care Center by CareMore’s interdisciplinary care team.[9] The team monitors disease-specific metrics to determine whether a patient requires more intensive management.[11] Roughly 30% of CareMore’s Medicare Advantage patients are engaged in a disease management program.[11] The company has seen particularly strong outcomes in its Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, End Stage Renal Disease and Diabetes programs.

CareMore employs Extensivist physicians who manage hospitalized patients and monitor their transition from the hospital back to the Care Center, Skilled Nursing Facility, or other site of care. The Extensivist acts as the leader of the CareMore clinical team, connecting the company’s PCP’s, Nurse Practitioners, Medical Assistants, and Case Management teams. CareMore leadership cites this cross-functional coordinating role as a key differentiator for the model and credits the Extensivists for readmission rates approximately 40% below the national average.[12]

In 2013, CareMore expanded into the Medicaid managed care space by partnering with another Anthem subsidiary, Amerigroup, to provide coverage in Tennessee, Iowa, and Ohio. Unlike its traditional model, in the Medicaid space CareMore serves only as the patient care delivery organization, while Amerigroup provides the insurance layer.[12] Though significant gains in clinical outcomes remain to be seen, CareMore Health System and Amerigroup believe the partnership has the capability to transform Medicaid patient care across the United States.[12][14]

In 2012 CareMore launched a Brain Health pilot geared towards providing support to patients suffering from dementia, with funding from the Center for Medicare and Medicaid Innovation (CMMI). The program initially consisted of 42 patients suffering from dementia and resulted in a decrease in patients’ ER utilization and fall incidence.[15] Critics of the program suggest the pilot’s findings are not scalable over large patient bases, though CareMore is currently expanding the program through its multiple markets. Supporters of the program highlight its focus on support for the caregiver, a role that is often neglected and subject to caregiver stress.

In 2016, CareMore began a partnership with ride service company Lyft. A 1 month pilot program in which 500 patients were provided transportation to a CareMore Care Center saw average wait times of 8 minutes. Both companies believe the partnership can significantly improve patient access to healthcare services.[16]

In 2015, CareMore began a partnership with Emory Health System in which the two entities will work together to redesign Emory’s clinical delivery infrastructure and coordination to ready the system for value-based care delivery.[17] The partnership features Emory’s adoption of the Extensivist physician role and the outpatient clinic focused on managing chronic disease. The partnership – among the first of its kind – has shown some notable improvements in care quality, with a 30-day hospital readmission rate of 8.9% for the cohort of patients cared for in the experimental model. While CareMore Health System and Emory Health System have remained optimistic about their partnership and the opportunities for other Academic medical centers to follow suit, some experts warn that the long-term results may not be as favorable as promised.[18]