Evercare to Offer First Medicare Advantage Special Needs Plan for People with Alzheimer's and Chronic Dementia

Evercare®, one of the nation’s largest health care coordination programs, today announced it has received approval from the Centers for Medicare and Medicaid Services (CMS) to offer the first Medicare Advantage Special Needs Plan for people with Alzheimer’s disease and chronic dementia. The Company also announced it will expand its portfolio of Chronic Illness Special Needs Plans, designed for people with a high burden of illness due to complex health conditions such as heart disease, diabetes and chronic obstructive pulmonary disease (COPD). Evercare continues its legacy of providing innovative approaches to health care coordination by offering the first Medicare Advantage Special Needs Plan designed exclusively for Medicare beneficiaries with Alzheimer’s disease and chronic dementia. The Evercare® Health Plan for People with Alzheimer’s Disease and Related Dementia provides full Medicare coverage as well as extra benefits and services tailored to meet the unique needs of people living with Alzheimer’s – a debilitating condition that affects five million Americans. With the plan benefits and services delivered through Evercare’s proven care model, members and their family caregivers will receive the support they need to cope with the stress and issues of living with Alzheimer’s. The plan will be available in Maricopa County, AZ. In 2008, Evercare will more than quadruple the availability of its Chronic Illness Special Needs Plans from seven to 34 states. These plans are designed for Medicare beneficiaries with complex and multiple chronic health conditions – individuals who are among the heaviest users of medical care in the nation. People with five or more chronic conditions make up just 20 percent of Americans age 65 and older, yet they account for 68 percent of all Medicare spending. By providing personalized attention focused on prevention, integration of treatments and ongoing health care coordination, as well as more benefits and services than those covered by Medicare alone, Evercare Chronic Illness Specials Needs Plans help members and their families manage their conditions, avoid complications and unnecessary costs. At the heart of all Evercare health plans is the unique and innovative Evercare Care Model. It provides the personal attention and coordinated care necessary to support people with complex and often multiple health conditions who often take several medications daily and receive care from an array of health care professionals. Nurse Practitioners and Professional Care Managers serve as trusted partners to Evercare members by helping to orchestrate communication and services so that physicians, health care providers, families and members are all working in concert to keep the member healthy and living as independently as possible. "Caring for people with Alzheimer’s disease and other chronic illnesses places extraordinary demands on those living with the disease, their families, health care providers, and the nation’s health care system. With the introduction of our Special Needs Plan for people with Alzheimer’s and the expansion of our plans for individuals living with chronic illness, Evercare will bring its proven Care Model to those who need it most,” said John Mach, M.D., a geriatrician and CEO of Evercare. Enrollment for the new Evercare Chronic Illness Special Needs Plans and the Evercare® Health Plan for People with Alzheimer’s Disease and Related Dementia begins November 15, 2007 for coverage beginning January 1, 2008. Evercare’s Explosive Growth, Proven Success Evercare was created 20 years ago, guided by the vision of two innovative Nurse Practitioners who observed that the neediest Medicare beneficiaries could benefit from more care delivered in a personalized, compassionate and highly focused way. Evercare’s deep understanding of the Medicare population’s complex needs and its ability to address those needs have fueled tremendous growth for the Company. Since the beginning of the decade, Evercare has greatly expanded its spectrum of offerings to meet the evolving health and lifestyle needs of people with more complex conditions wherever they live and has nearly tripled its member base since 2003 Data shows that the pioneering Evercare Care Model delivers greater access to medical and non-medical services, better health outcomes, and lower costs to Medicare and Medicaid. According to a report by Robert Kane, University of Minnesota, and as reported in the Journal of American Geriatrics Society (2003), the Evercare approach and continuity of care has been shown to help prevent some problems before they become serious — reducing hospitalizations for nursing home residents by 45 percent and trips to the emergency room by 50 percent. In addition, 97 percent of family members/other responsible parties are satisfied with Evercare’s plan for nursing home residents, while 91 percent of members and responsible parties in Evercare Medicaid plans are satisfied and 95 percent intended to continue with Evercare. Today, Evercare applies the innovative Evercare Care Model to those in institutional, community and hospice settings, and who are eligible for support through both Medicare and Medicaid. In addition, Evercare offers services for caregivers and for individuals in advanced stages of illness through Evercare™ Solutions for Caregivers and Evercare™ Hospice & Palliative Care, respectively. The Birth of Special Needs Plans – Medicare Reform Special Needs Plans are a special type of health plan designed to ensure that the people who need the most care – those with complex health care needs and chronic conditions – receive it in a personalized, coordinated way. By emphasizing preventive care and early intervention, SNPs reduce unnecessary hospitalizations, emergency room visits, and the over-prescribing of medications. Congress looked to Evercare as a primary model for the creation of Special Needs Plans under the Medicare Modernization Act of 2003 (MMA), and today, Evercare is the leading provider of SNPs in the continental U.S. Special Needs Plans help make health care more effective and cost-efficient. While people with five or more chronic conditions made up just 20 percent of all Medicare beneficiaries in 2004, they accounted for over two-thirds of the program’s costs according to Partnership for Solutions in a 2004 report. Evercare will again be working with Congress to ensure that Special Needs Plan authority is reauthorized so that these kinds of innovative plans can continue to be made available beyond 2008. "Special Needs Plans are a vital part of the health care system in that they allow high-risk Americans, or people with the most complex, most burdensome conditions, to receive the level of care and support they need," said Richard Bringewatt, President of the National Health Policy Group and Chair of the Special Needs Plan Alliance, a national leadership organization of leading Specialty Healthcare Programs and the only national organization specifically dedicated to representing the needs and interests of Special Needs Plans. "The SNP Alliance is committed to stabilizing Special Needs Plan legislation for the long-term so that innovative organizations like Evercare, which has a legacy of serving the special needs of this population, can continue to do so." About Evercare Evercare is one of the nation’s largest care health coordination programs for people who have long-term or advanced illness, are older or have disabilities. Founded in 1987, Evercare today serves more than 150,000 people nationwide through Medicare, Medicaid and private-pay health plans, programs and services – from health plans for people in community and skilled nursing settings, to caregiver support and hospice care. Evercare offerings are designed to enhance health and independence, and in the complex world of health care, make getting care easier. Evercare is part of Ovations, a division of UnitedHealth Group (NYSE:UNH) dedicated to the health care needs of Americans over age 50. For more information about Evercare, call 1-888-834-3721 (TTY 1-888-685-8480) or visit EvercareHealthPlans.com.