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Carelon Health, (formerly CareMore) a subsidiary of Elevance Health through its Carelon brand, is an integrated health plan and care delivery system for Medicare and Medicaid patients. The company was founded in 1992 as CareMore by Sheldon Zinberg and Johnn Edelston, President of HealthPro Associates through the merger of Community IPA managed ...
Chronic care management encompasses the oversight and education activities conducted by health care provider to help patients with long term illness and health conditions such as diabetes, hypertension, lupus, multiple sclerosis, and stopping of breathing during asleep learn to understand their condition and live successfully with it.
The Guided Care model was first tested in a pilot study in the Baltimore-Washington D.C. area during 2003–2004. Patients who received Guided Care rated their quality of care significantly more highly than patients who received usual care, [3] and the average insurance costs for Guided Care patients were 23 percent lower over a six-month period.
The term accountable care organization was first used by Elliott Fisher in 2006 during a discussion of the Medicare Payment Advisory Commission. In 2009, the term was included in the federal Patient Protection and Affordable Care Act. [2] It resembles the definition of Health Maintenance Organizations (HMO) that emerged in the 1970s. Like an ...
Transitional care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness. Older adults who suffer from a ...
Between 2016 and 2022, the Oncology Care Model by the Centers for Medicare and Medicaid Services financially incentivized "122 practices and 5 commercial payers" to improve the quality and coordination of care for Medicare patients, including through patient navigation. [7]
Geriatric care management is the process of planning and coordinating care of the elderly and others with physical and/or mental impairments to meet their long term care needs, improve their quality of life, and maintain their independence for as long as possible.
MSP provides for a coordination of benefits period between Medicare and private health insurance plans for individuals entitled to Medicare solely on the basis of ESRD. If an individual is entitled to Medicare because of ESRD and is covered by an Employer Group Health Plan (EGHP), the EGHP is the first payer (primary) for the first thirty months.