In response to these changing tides, Evernorth leveraged more than 25 years of enterprise experience with in-home primary care, post-acute care (PAC) management, and advanced analytics, as well as our broader enterprise assets, to create a game-changing offering: Evernorth Care at Home.
Evernorth Care at Home
Evernorth Care at Home is a powerful offering brought to you by the combined services of eviCore healthcare + Alegis Care + Accredo + Health Plan Partners.
A Shifting Health Care Landscape
The United States healthcare system is seeing a growing shift toward home-centered care delivery, virtual care, and digital telehealth, further reinforced by the recent COVID-19 pandemic. However, resources to support in-home care are often fragmented, non-existent, or poorly coordinated.
It’s About Whole Person Health
Holistic Patient Care
While most of these services can be used separately, Evernorth Care at Home enables our clients to access configured, integrated solutions, presenting a single source for what have traditionally been fragmented and uncoordinated applications of services. The result is improved outcomes, cost management, and member satisfaction.
Government Programs Expertise
Our government programs expertise (e.g., in Medicare and Medicaid) provides us unique insights across the entire population, supporting the patient’s journey from hospitalization, to facilities, to home, and in-home care. We can apply a wide range for government programs, consulting with our clients regarding specific populations, and configuring capabilities to drive affordability and quality metrics.
Open Architecture
To tailor a program that best complements the unique needs of each payer client, we apply an “open architecture” approach that provides flexibility in leveraging not only our own assets and capabilities, but also our clients’ capabilities and third-party resources. Factoring our clients’ preferences and individual market considerations, this model maximizes the effectiveness of our solution for each client’s situation.
Funding Models that Guarantee Results
Our offerings incorporate a risk-based funding model, in which Evernorth assumes financial responsibility for the total delegated medical spend (or membership), guaranteeing our clients savings from day one of management.
Evernorth Care at Home
With more than 1.5 million members under management, our PAC solution can shape the facility episodes that lead to home (skilled nursing facilities, long- term acute care facilities, and inpatient rehabilitation facilities) by applying PAC tools.
Evernorth Care at Home redefines the scope of Post-Acute Care, by incorporating in-home, virtual, and telephonic services. In addition, our program can provide a unique, comprehensive approach to DME management.
- Transition of Care
- Facility Recovery
- Recovery at Home
- DME Management
- Sleep Management
Evernorth Care at Home leverages larger enterprise assets, including Alegis Care, a physician-led care management organization that works side-by-side with patients in an in-home setting to deliver direct care across the managed population, including Chronic Care, Palliative Care, and Health Assessments, supported by funding models that allow us to assume risk on the members’ total spend, not just delegated management.
- A New Approach to (Re) Admission Avoidance - Our vision is not only to reduce hospital readmissions but provide proactive care limiting initial hospital admissions.
- Population Health First - We identify and flag healthy to chronic members, guiding and engaging with them to create a positive care experience.
- Integrated Movement and Coordination - We drive movement to home-centered primary care and care delivery while coordinating all aspects of the experience: care coordination, digital telehealth, and better management of chronically and critically ill patients.
- Seamless Member Experience - Evernorth Care at Home can serve as a convener/coordinator of disparate offerings, leading to a more integrated and cohesive member experience.
As a strategic approach to home health, DME, and home infusion management, Evernorth has integrated existing regional networks to create national Home/DME/Sleep/Infusion Networks, serving over 11 million members. This will enable a variety of capabilities to deliver more effective care in an in-home setting.
- DME
- Skilled Care
- Sleep Therapy
- Infusion Therapy
More to explore