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Florida Blue Medicare Launches Primary Care Program

Florida Blue Medicare, the state’s Medicare Blue Cross and Blue Shield plan, is partnering with Emcara Health to provide eligible members with access to primary care at home.

The collaboration reflects how payers are increasingly turning to home care organizations of all shapes and sizes.

“There’s an advantage to being able to go into a member’s home and see what challenges they face,” Dr. Elizabeth Malko, vice president of Medicare solutions and medical director of Florida Blue Medicare, told Home Health Care News. “I think the pandemic was like a wake-up call.”

Under the parent company GuideWell Mutual Holding Corporation, Florida Blue Medicare, based in Jacksonville, Florida, offers a wide range of plan options, including Medicare Advantage plans.

Launched last October by GuideWell’s subsidiary PopHealthCare, Emcara Health is the company’s national values-based medical group. One of the main areas of care for Emcara Health is advanced primary care at home for the elderly.

With this partnership, Florida Blue Medicare will provide a range of home care services to members in 17 counties in the Jacksonville, Orlando, Miami, Southeast Florida, Tampa Bay and Pensacola areas.

That said, the program is more than just a shallow home calling program, according to Malko.

“It ‘s not like you have one [primary care physician] which has an office three miles away and from time to time they come to see you, “he said.” The main location for care will really be in your home. Your primary care physician will always come to your home for your visits. ”

Florida Blue Medicare’s focus on primary care at home comes from the fact that the Medicare population demands it. Moving home services allows the organization to address the gaps in care among its members.

“We know that, especially in the Medicare population, people develop hearing and vision difficulties,” Malko said. “They may lose some of their support systems. Transportation can be a challenge. If you’re postoperative, you may have mobility issues. There may be all sorts of issues around health care.”

In general, the program will offer exams, tests, vaccinations, and even pictures at home.

It will also give Florida Blue Medicare members access to a primary care physician at home, home care from a nurse practitioner or nurse practitioner, a registered nurse, and a community health worker responsible for connecting members. with local services. such as transportation and food programs.

In order to provide this home care, Florida Blue Medicare used Emcara Health to take responsibility for primary care.

“We provide comprehensive and coordinated primary care for these patients with complex medical needs,” Dr. Coleman Pratt, medical director of Emcara Health, told HHCN. “We are working closely with the health plan to identify which patients can benefit most from our services. We also work closely with the health plan to share back and forth information. Information is very important. They are alerting us to key information about the patient’s needs. ”

Pratt believes that the key to improving the quality of care is to maintain continuity of care when entering the home.

“If we look at comparative data from countries around the world, those countries that focus on primary care, access to care and also the coordination of services show, in many cases, an improvement in results. health care while spending less on overall health spending, “he said. dit. “This is really in the DNA of how we work, and we’re really trying to internalize that message. Florida Blue Medicare really shares that vision.”

In context, U.S. adults are less likely to have a regular doctor or a long-term relationship with a primary care provider.

In addition, home visits or out-of-hours care are the lowest in the United States, according to the 2019 and 2020 Commonwealth Fund International Health Policy Surveys.

Looking ahead, Florida Blue Medicare plans to expand the program to Osceola, Polk, Brevard, Marion, Sumter, Charlotte, Collier and Lee counties later this year.

“You have to be very careful when deploying a great program like this, so that you don’t get ahead of your skis,” Malko said. “We want to do it in a very measured way. I certainly hope that over time we get this program in every county in the state, but it will be based on both geographic density and need.”

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