MANAGED CARE

ElderCare's multi-factorial fall prevention program has been consistently shown to reduce fall-related hospitalizations by 50+% and rehab admissions by 60+%.

In three separate studies, involving 10,000 Medicare enrollees (dual-eligibles) in Pennsylvania, Florida and New York during the past decade, Medicare enrollees receiving ElderCare's interventions fell less frequently, less injuriously, in a less costly manner - - across time (pre- and post-) and across treatment and control groups.

The Florida and New York studies were mostly conducted among fee for service enrollees but all of the Pennsylvania participants were in managed care organizations (Oxford, Health Partners, AmeriChoice and Keystone). Beyond the experimental group procedures, we monitored MCO outcomes.

In the year after ElderCare began its work in Philadelphia, the four plans experienced significantly lower frequencies of fall-related fractures than they had experienced in the year before the ElderCare fall prevention program started.

Specifically, fall-related fractures were reduced by these levels

• hip/pelvic fractures declined by 62%
• femur fractures declined by 47%
• ankle fractures occurred 36% less frequently in the first year of our project than in the prior year.

The long term care staff of the Commonwealth of Pennsylvania explicitly expressed confidence in the accuracy of these fall-related fracture data. ElderCare's rigorous methodology means that the savings for payers are observed, not estimated. ElderCare saved $2 to $3 for every $1 invested.

ElderCare can help Medicare Advantage Plans reduce their cost of care even more dramatically by targeting members at the highest risk of fall-related costs. ElderCare can improve its performance on three (3) of the star rating variables by concentrating on: a.) osteoporosis management; b.) physician/patient discussion of falls management; and c.) the physicians' monitoring of patients' exercise and physical activity.

ElderCare is prepared to work with Medicare Advantage across America and is uniquely qualified to work on Medicaid dual-eligible demonstrations.

Medicaid Managed Care:

It should be noted that all of ElderCare's nationally recognized clinical trials were done on dual eligibles. We know how to reduce nursing home admissions for falls by 60+%. We also know how to reduce rehospitalizations for nursing home residents.