NEW YORK, Dec. 16 /PRNewswire/ -- ActiveHealth Management, Inc. (ActiveHealth) today announced that together with Aetna, it will provide health management services to more than 20,000 seniors in the Chicago metro area. Through Aetna's recently awarded prime contract under the Chronic Care Improvement Program (CCIP), ActiveHealth will support Aetna in providing clinical decision support for this Medicare population with its proprietary CareEngine(R) System, a program currently used to power Aetna's MedQuery(R) product to improve the quality of care for its members. The CCIP expands the relationship between ActiveHealth and Aetna and this proven effective program.
Administered by the Center for Medicare & Medicaid Services (CMS), the CCIP pilot program awarded to Aetna will allow the company to apply the beneficial features of its care management services to traditional fee-for- service Medicare beneficiaries with certain chronic conditions, such as diabetes and congestive heart failure. The initiative is designed to help improve health outcomes for these Medicare recipients, reduce medical costs, and improve participant and medical provider satisfaction. The awards are a part of CMS's implementation of the Medicare Modernization Act of 2003.
Participation of Medicare beneficiaries in the CCIP program is voluntary, and all services will be provided to participants at no charge. Additionally, the program does not change access to members' traditional fee-for-service Medicare benefits.
Designed to improve quality of care and thereby reduce costs, ActiveHealth's patented CareEngine system uses a proprietary clinical technology platform to apply a comprehensive set of evidence-based clinical rules to aggregated patient medical claim, laboratory and pharmacy data. It then generates patient-specific treatment improvement suggestions called Care Considerations. The Care Considerations are then communicated with the goal of helping to prevent avoidable clinical complications and hospitalizations. These services have been shown to significantly improve clinical outcomes and reduce medical costs across a covered population. The CareEngine currently provides coverage for more than 6 million commercial, Medicare and Medicaid lives.
"By working collaboratively with Aetna on this initiative, we are supporting patients and their physicians with specific treatment interventions with the goal of improving patient care," said Lonny Reisman, MD, CEO of ActiveHealth. "We are excited to be a part of this program, as it is part of a long term, expanding relationship with Aetna, and serves as yet another recognition of the impact that ActiveHealth solutions have had on Medicare populations in need of help in managing chronic conditions such as congestive heart failure and diabetes," he added.
About ActiveHealth Management
Founded in 1998 by physicians, ActiveHealth is an information-driven health management and data analytics company that helps health plans and self- insured employers take full advantage of evidence-based medical knowledge to improve patient care and reduce healthcare costs. Leveraging its patented CareEngine platform, ActiveHealth combines clinical expertise with innovative medical information technology to enable doctors and patients to work together to reduce medical errors, improve patient safety, improve overall health outcomes and reduce costs. More than 6 million health plan members have benefited from ActiveHealth health management programs.
The ActiveHealth suite of services is designed to seamlessly integrate with insurers' existing care management systems. Services include URAC- accredited disease management, utilization management and case management services in addition to clinical predictive modeling, performance measures and data analytics through Heath Data Management Solutions, Inc. (HDMS), a wholly owned ActiveHealth subsidiary. The company's unique approach to physician and member engagement enables it to communicate treatment improvement opportunities in time to avoid serious and costly adverse clinical events.
ActiveHealth is based in New York City and employs more than 220 people. The company has additional offices in Chantilly, Virginia; Chicago, Illinois; and Cleveland, Ohio.
CareEngine(R) is a registered mark of ActiveHealth Management, Inc.
MedQuery(SM) is a registered mark of Aetna.
ActiveHealth Management, Inc.CONTACT: John C. Caceres, +1-212-590-2647, jcaceres@ahm-usa.com, or MarySgammato, +1-212-981-8313, msgammato@ahm-usa.com, both of ActiveHealthManagement