BALTIMORE, Sept. 29 /PRNewswire/ -- XLHealth announced today that the Centers for Medicare and Medicaid Services (CMS) has granted the company approval to market a new plan that focuses on the unique health care needs of chronically ill Medicare beneficiaries. XLHealth is one of only a few companies throughout the country chosen by CMS to offer a specialized plan for those living with chronic illness. The Baltimore-based company will be the first and only to offer a health plan that provides disease management services, along with a Medicare Part D drug benefit, to the 98,000 chronically ill Medicare beneficiaries in Maryland who qualify for the new program.
In recognition of the fact that some Medicare recipients require specialized care, the Medicare Modernization Act of 2003 allows Medicare Advantage organizations to offer Special Needs Plans (SNPs) to three groups of Medicare beneficiaries: those with chronic illnesses, those residing in nursing homes, and low-income individuals who qualify for both Medicare and Medicaid.
XLHealth was approved to offer a SNP to Medicare beneficiaries who are living with complex diabetes, congestive heart failure and/or end-stage renal disease (ESRD). The new plan, named Health Support Plus, will provide members with disease management services, a Medicare Part D drug benefit and medication management services. To join, members:
-- must be eligible for Medicare -- have diabetes, CHF and/or ESRD -- reside in one of the plan’s service areas: Baltimore City and Anne Arundel, Baltimore, Carroll, Harford, Howard, Montgomery and Prince George’s counties
“We’re looking forward to bringing our proven disease management program to Maryland,” said Harry Leider, M.D., XLHealth’s chief medical officer. “Our experience has shown us that offering greater levels of service to patients and their physicians is worth the extra effort. Patients are more likely to follow their physicians’ directives, take their medications, monitor their daily symptoms and schedule preventive screenings. The results - improved quality of life, better health outcomes, reduced rates of hospitalization and lower health care costs - speak for themselves.”
Each member will be assigned a Health Support Plus care team comprising a dedicated local health care manager, local field nurse, telephone coach nurse and pharmacist - all of whom will work closely with the beneficiary’s main physician to coordinate services and provide optimal care. In addition, members will receive other services and benefits not offered by most Medicare plans, such as:
-- access to an open network of physicians and other health care providers -- freedom to join the program year-round -- comprehensive prescription drug coverage under Medicare Part D with a formulary specifically designed for chronically ill members -- medication and appointment reminders -- home nursing visits -- preventive screenings -- health education and coaching -- assistance with health care devices and equipment purchases -- patient advocacy support -- enhanced disease management services, such as transportation, not offered under traditional Medicare
XLHealth’s Health Support Plus plan also will provide participating physicians with a variety of services designed to support their efforts to care for their chronically ill patients. They include services not offered by most Medicare plans, such as: compensation for time spent on non-Medicare covered services; an open-access model that doesn’t require referrals, authorizations or pre-certifications; no retroactive denials; collection of medical histories in advance of office visits; and easy-to-read reports containing all of each patient’s up-to-date information. Dr. Leider explains, “Health Support Plus is founded on the premise that the plan and providers are truly partners in offering an extremely relevant, affordable, high-quality health care option to chronically ill seniors.”
In preparation for the plan’s launch, the company has recruited physicians from all specialties. To date, the company has built a comprehensive network and contracted with more than 2,500 health care providers, including leading cardiology, nephrology and pulmonary groups, as well as hundreds of primary care physicians, hospitals and other health care practitioners. The company also received a license to operate Health Support Plus from the Maryland Insurance Administration.
Health Support Plus enrollment begins November 15, 2005. Members joining between then and December 31, 2005, will begin receiving plan benefits on January 1, 2006. Chronically ill Medicare beneficiaries interested in learning more about the plan can call (800) 711-1656 and speak to a Health Support Plus representative.
About XLHealth
XLHealth (http://www.xlhealth.com) has been at the forefront of disease management innovation since its inception. Founded by physicians, many of whom were affiliated with Johns Hopkins, XLHealth supplements the more customary remote telephone “call-center” or direct mail support with ongoing, face-to-face meetings with nurses and physicians. XLHealth also uses tight coordination of care, behavior modification, and in-depth patient profiling integrated with claims, pharmacy, and lab information to generate sophisticated, predictive modeling. The company’s programs prevent avoidable and expensive disease complications and hospitalizations. XLHealth was recently awarded the Disease Management Association of America’s (DMAA) Recognizing Excellence Award for “Best Disease Management Program: Medicare.”
XLHealth
CONTACT: Kristin Brunnworth for XLHealth, +1-410-962-8500 x138,klb@planitagency.com
Web site: http://www.xlhealth.com/
