Care Improvement Plus Chronic Condition Special Needs Plans
Care Improvement Plus' Chronic Condition Special Needs Plans (C-SNP) are uniquely designed for Medicare beneficiaries with diabetes and/or heart failure.
With money-saving medical and prescription drug coverage, health education, and a variety of valuable extra benefits and services, Care Improvement Plus' Chronic Condition Special Needs Plans help Medicare beneficiaries take steps to better manage their daily health.
Care Improvement Plus currently offers three C-SNP plan options:
- Silver Rx (Regional PPO) - for those with diabetes and/or heart failure and who also have Medicare and full Medicaid (QMB, QMB Plus)
- Gold Rx (Regional PPO) - for Medicare beneficiaries with diabetes and/or heart failure who do NOT receive Medicaid benefits or assistance through the government's Low-Income Subsidy "LIS" program
- Gold Rx Advantage (Regional PPO) – for those with diabetes and/or heart failure who receive financial assistance through the government's Low-Income Subsidy (LIS) program but do not have full Medicaid
Why offer a health plan for those in Medicare with chronic health conditions?
According to a recent Congressional Budget Office report, beneficiaries with multiple chronic conditions currently account for 75% of Medicare spending1. These beneficiaries have complex healthcare needs such as multiple prescriptions to manage and numerous doctors. In addition, beneficiaries with chronic conditions are at a higher risk of developing complications and requiring hospitalization. C-SNPs provide customized support and added benefits aimed at improving the quality of care provided to these beneficiaries, and helping to control their healthcare costs.
Key Diabetes and Heart Failure Statistics:
- According to a February 2009 study in Diabetes Care, more than 32 percent of people age 65 and older have diabetes.2
- Heart failure is the cause of nearly 285,000 deaths in the United States each year, and the rate of heart failure has more than doubled over the past two decades.3
- Total cost of Heart Failure – United States Direct and indirect costs: $34.8 billion.3
Key Statistics on the Power of Chronic Care Management:
- Complex case management services for beneficiaries with diabetes can reduce the rate of hospital admissions by over 50%. 4
- A 12 to13 point reduction in blood pressure can reduce the incidence of heart attacks by 21%, strokes by 37%, and the total number of cardiovascular disease deaths by 25 %.4
- Improved blood sugar control in people with diabetes can reduce their risk of developing diabetic complications such as blindness, kidney disease and nerve damage (which can lead to amputation) by 40%.5
Sources:
- 1 Congressional Budget Office (2005) "High-Cost Medicare Beneficiaries"
- 2 Cowie, C. et al. Full Accounting of Diabetes and Pre-Diabetes in the U.S. Population in 1988–1994 and 2005–2006. Diabetes Care February 2009 32:287-294; published ahead of print November 18, 2008, doi:10.2337/dc08-1296
- 3 Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. Dec 10 2002; 106(24):3068-3072.
- 4 Prevention Works: CDC Strategies for a Heart-Healthy and Stroke-Free American. 2006. http://www.cdc.gov/dhdsp/library/prevention_works/index.htm
Statistics compiled from the American Heart Association's Web site, www.AmericanHeart.org
This page was last updated on: 7/9/2010 9:58:23 AM
