Designed for Residents of Metro-area Long-term Care and Assisted Living Communities
In collaboration with Genevive, Medica and 9 other senior care organizations, Presbyterian Homes & Services (PHS) is introducing specialized Medicare Advantage plans exclusively designed for residents living 90 days or longer in long-term care, memory care or assisted living in the Twin Cities metro area.
Last year, PHS introduced special Medicare Advantage plans (D-SNP) in partnership with Medica, Blue Cross Blue Shield and UCare targeted to individuals dually eligible for Medicaid and Medicare at 14 PHS communities. In 2019, PHS also acquired a 50% share in Genevive, a leading geriatric primary care provider in the Minneapolis/St. Paul metro area serving around 5,500 older adults.
Now, PHS introduces Medica Advantage Solution® PartnerCare (HMO I-SNP), the new Institutional Special Needs plan offered through a unique collaboration with Genevive, Medica and 9 more senior care organizations. The plan is designed expressly to meet the often complex health needs of adults living in long-term care nursing, assisted living and memory care settings. The plans will be available for a January 1, 2020, effective coverage date. They are the first in the region to offer Genevive’s integrated care team expertise aligned with Medica’s care model experience across a diverse number of residential settings.
The plans will be offered exclusively to eligible individuals residing with the 10 senior care providers: Benedictine Health System, Cassia an Augustana/ELIM affiliation, Catholic Eldercare, Episcopal Homes of Minnesota, Goodman Group, North Cities Health Care Inc., Presbyterian Homes & Services, Saint Therese, Volunteers of America and Walker Methodist. Together, these organizations are among the largest in the region, representing 78 Twin Cities areas and serving 5,500 individuals in long-term care, assisted living and memory care settings.
Genevive, co-owned by Allina Health and PHS, will provide primary care and care management services and act as the contracting agent on behalf of Medica with the participating senior care organizations representing approximately 5,500 eligible individuals. Medica has designed and offers the health insurance plan, which includes coverage for prescription drugs, transportation, dental, vision and hearing care. Medica-participating providers will provide hospital services subject to appropriate placement based on clinical considerations and patient choice.
Chief among the unique features of the strategic collaboration is a holistic model of care delivered by Genevive through a multidisciplinary team with expertise in providing care to people with complex conditions. The team includes physicians, nurse practitioners, care coordinators, specialist providers, a pharmacy consultant, anticoagulation team and ancillary service providers; all connected to each individual’s local care team at his or her long-term care or assisted living community.
“We believe Medica Advantage Solution PartnerCare is one of the largest rollouts of an Institutional Special Needs Plan (I-SNP) in the nation,” said Amanda Tulfano, Genevive CEO. “Genevive, Medica and our senior care partners share a commitment to a person-centered approach with services that reflect each person’s strengths, goals, preferences and assessed needs. Our mission at Genevive arose from a vision to establish a practice entirely focused on meeting the needs of older adults. This collaboration is an incredible opportunity for us to partner with Medica and 10 premier senior care providers to further develop what will likely be a national model of care to simplify and align the best possible quality of care for older adults with complex needs.”
Said Tom Lindquist, Senior Vice President and General Manager of Government Programs at Medica, “Medica is pleased to partner with Genevive and the 10 senior care organizations to make these Medica Advantage Solution PartnerCare health insurance plans available to a population that deserves benefits expressly designed to address their very special needs. We are confident our partners will provide constant attention to the individuals we serve and their involved parties, and also help ensure our members experience the fullest life possible.”
Medica Advantage Solution PartnerCare’s underlying philosophy is individualized care that focuses on health promotion and prevention through a person-centered approach that ensures services reflect the person’s strengths, goals, preferences and assessed needs. It provides assistance that allows people to live at the highest level of independence desired.
“This is a mission-focused collaboration,” noted Dan Lindh, President & CEO of PHS. “It helps us meet the societal need for a value-based care model in a focused structure. Senior care organizations provide housing and services that represent a significant portion of the determinants of overall health. Genevive has demonstrated success in bringing exceptional care to older adults through its unique combination of primary care home visits, care management and value-based contracting. By taking financial accountability through this value-based contract with Medica and Genevive, senior care providers can expand wellness and other supportive services for a growing number of older adults, many of whom cannot afford the services and supports that lead to better living and have been proven to reduce the rate of unwanted invasive medical care.”
Added Dr. John Mach, Medica Chief Medical Officer, “Our community needs this type of partnership to offer a unique and different experience for members. We’re excited for the opportunity to combine Medica’s excellent history in the senior insurance space with Genevive’s long standing and innovative clinical model, all coordinated with the senior care providers where the members live.”
Ric Magneson, Chief Financial Officer at Allina Health, summarized, “This partnership continues to extend Allina Health’s commitment to serve seniors beyond our own walls by leveraging and expanding access to Genevive’s comprehensive geriatric care model.”
Genevive provides expert, compassionate primary care and care coordination focused exclusively on meeting the needs of aging individuals in long-term care, transitional care, and home settings. Genevive has successfully made the leap from fee-for-service to value-based care and has a proven track record of improving quality outcomes. Formerly Geriatric Services of Minnesota, Genevive is a standalone healthcare organization co-owned by Allina Health and Presbyterian Homes & Services consisting of over 120 staff members including physicians, nurse practitioners, nurses, and social workers dedicated to serving seniors throughout the Twin Cities and greater Minnesota. For more information, visit www.genevive.org.
Medica is a non-profit health plan headquartered in Minneapolis. The company serves communities in the heart of America by providing health care coverage and related services in the employer, individual, Medicaid and Medicare markets. It operates in Minnesota, Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin.
Medica's vision is to be trusted in the community for our unwavering commitment to high-quality, affordable health care. Medica's annual report, which includes the organization's community involvement activities, is available online.