Inspiris, the Brentwood, Tenn.-based provider of care management for the frail elderly, announced today a new contract with Humana Inc. to provide care for eligible enrollees in the Daytona/Ormond Beach metropolitan area.
Inspiris is an expert care and care management company focused on improving the quality of life for the frail elderly, the chronically ill and those with disabilities, while reducing the cost to Medicare Advantage, Medicaid and commercial health plans. Beginning Nov. 1, Inspiris will bring its nurse-practitioner led teams to serve some 17,000 Humana Medicare Advantage members in the Daytona/Ormond Beach metropolitan area.
Inspiris will provide its nursing home-based services, led by a registered nurse practitioner in coordination with a physician, to Humana enrollees in custodial care. Under the long-term care program, signs and symptoms of declining health status in frail, elderly patients are recognized early and appropriate adjustments to therapy are made on a timely basis. The model has proven to effectively reduce costs, decrease hospital admissions and utilization of skilled nursing care, improve outcomes, and to improve patient and family satisfaction.
“Our nurse practitioners visit patients several times a month, so they can see small changes in a member’s condition and adjust care before they become major health issues,” said Mike Tudeen, Inspiris’ president and chief executive officer. “This greatly improves the quality of life for patients who can receive enhanced care where they live.”
Under the contract with Humana, Inspiris will also coordinate care for enrollees in the post-acute care setting for short-term rehabilitation. Through the program, an Inspiris nurse practitioner visits the patient and makes a clinical assessment, reviews the therapy plan and coordinates care. The Inspiris team also communicates with the patient’s primary care physician, and works with the patient’s family to ensure a smooth transition from the short-term facility.
“Primary care physicians typically visit their patients in custodial care once every 60 days, and often coordinate care for their patients in custodial and skilled nursing care telephonically,” said Steve Lee, MD, chief medical officer, senior products, for Humana North Central Florida. “The Inspiris nurse practitioner-led model can help detect a patient’s declining health status and coordinate care with the primary care physician before symptoms become severe. We are pleased to offer our Daytona-area Humana enrollees this enhanced care model through our partnership with Inspiris.”
The need for coordinated, quality care for the frail elderly is expanding as the first baby boomers reach retirement age. Between 2005 and 2015, the U.S. Census Bureau projects the over-65 population to increase by almost 28 percent, while the total U.S. population increases by just 9 percent. The number of those over age 85 is expected to increase 16.8 percent over the same period. About 20 percent of this population is in a long-term care facility, and about one third report fair or poor health.
Studies published in the Journal of the American Geriatrics Society and Gerontologist show that a combination of intense management by nurse practitioners in the nursing-home setting can reduce hospitalizations for nursing home residents by 45 percent and emergency room visits by 50 percent. Analysis of Medicare claims data for an Inspiris client population indicated the Inspiris long-term care program reduced hospitalizations by 74 percent and emergency room admissions were reduced by 46 percent.
“The Inspiris model emphasizes coordinated, consistent care focused on prevention, as well as chronic and acute condition management, delivered in the appropriate setting,” Tudeen said. “We are delighted that our partnership with Humana will extend these services to thousands of members in the Daytona/Ormond Beach market.”
Inspiris is a unique health care management company focused on improving the quality of life for the elderly population, while reducing the cost to Medicare Advantage health plans. Inspiris partners with individual health plans to provide acute, post- acute, custodial and hospice-care programs that address the needs of the plan’s membership. For more information about Inspiris, visit http://www.Inspiris.com.
About Humana Inc.
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health benefits companies, with approximately 11.3 million medical members. Humana offers a diversified portfolio of health insurance products and related services – through traditional and consumer-choice plans – to employer groups, government-sponsored plans, and individuals. Over its 46-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.