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Q&A: AultCare’s PrimeTime Health Plan Approach To Medicare Advantage Care Coordination

posted by AultCare

on November 8, 2016

Founded on the values of affordable pricing and service excellence, Ohio-based AultCare is committed to better serving its Medicare Advantage members. Care coordination plays a key role in AultCare delivering high-quality, affordable care. Below, the health plan shared why it’s important to work with providers to help Medicare Advantage patients get the care they need, when they need it.

What do seniors want most from their health coverage? And how does Medicare Advantage deliver the results they need?

AultCare’s PrimeTime Health Plan works diligently to understand what our seniors want from their health plan coverage.  We understand that our seniors are looking for a plan that is affordable while focusing on quality as well as service. AultCare’s PrimeTime Health Plan delivers results by being an advocate for our Medicare Advantage Prescription Drug (MAPD) members by focusing on coordination of care of our members.

Why is case management so crucial to achieving positive health outcomes?

AultCare’s PrimeTime Health Plan Case Management initiative is a critical component of our overall Care Coordination program, which was established to manage the health of our MAPD population. With a proactive and collaborative approach, the program achieves patient-centered care and utilizes available resources to promote quality and cost-effective outcomes. Especially important is the working relationship we have directly with the members and their providers.

In Medicare Advantage, what does better value, better services, better health look like to seniors?

The Centers for Medicare and Medicaid Services (CMS) understands the importance of better value, better services, and better health for seniors. The agency has developed a rating system for MAPD plans. This rating system is focused on the performance levels of MAPD plans based on specific criteria in several categories, which include: staying healthy, managing chronic conditions, plan performance, member experience and customer service.

AultCare’ s PrimeTime Health Plan has been recognized as a 5 out of 5-star rated plan by CMS for the 2017 Star Rating year.

“It is a major success to be recognized by The Centers for Medicare and Medicaid Services with their highest recognition in quality and performance,” said Rick Haines, President & CEO of AultCare.

How does AultCare help its Medicare Advantage members understand and take control of their health?

Our goal for our members is to be active participants in their health. We strive to engage our members in partnerships with their primary care physician and interdisciplinary team. We provide care coordination through the interaction of physicians, nurses, pharmacists and other healthcare professionals. Together we help our enrollees navigate the health care delivery system.

 Do you have any Medicare Advantage success stories you’d like to share?

We have received many success stories from our AultCare PrimeTime Health Plan members. Key themes are centered on personal interaction while increasing wellness, decreasing complications of chronic conditions, and working alongside the patient to help them simplify the complexity of health care. We are encouraged by the success stories that we hear from our members.

Our providers recognize the value of a partnership with AultCare’s PrimeTime Health plan. They tell us frequently that they appreciate our transparent approach to sharing actionable quality and satisfaction information. We work collaboratively with them in our combined efforts to coordinate care for our shared members.

We take pride in our personal approach to providing benefits to our members. We continually evaluate our member’s needs and evolve our care coordination programs to meet those needs.

This interview has been condensed and edited for length and clarity.