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Aetna Better Health and IlliniCare Health Plans, on Behalf of the State of Illinois, Partner With General Medicine, P.C. to Manage and Provide Physician and Nurse Practitioner Services in Nursing Homes and Long-Term Care Facilities

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Aetna Better Health and IlliniCare Health Plan, health plans that provide management services to the Illinois Department of Healthcare and Family Services’ Integrated Care Program for older Adults and Adults with Disabilities, have contracted with General Medicine, P.C. to manage the program’s physician and nurse practitioner services (SNFist) for members residing in nursing home and long-term care facilities.

Under the health plans, an innovative model of coordinated medical care delivery has been developed.  Physicians and nurse practitioners employed by General Medicine and who have experience in providing care for individuals needing institutionalized long-term care, including individuals with developmental disabilities, multiple chronic illnesses and severe mental illness, will perform on-site assessments of health plan members.  They also will provide oversight of the patient’s individual care plan, including treatment, intervention and follow up. The goal of this program is to significantly improve the quality of patient care by augmenting and coordinating the individual care of members. This model will result in members receiving appropriate and timely clinical interventions, thus reducing unnecessary emergency room visits, hospital admissions and readmissions.

“Effective management of care through early intervention and assessment is key to improving health care quality for these members, who include some of our state’s most frail and medically needy,” saidWilliam Gerardi, M.D., chief medical officer for Aetna Better Health of Illinois.  “The General Medicine clinicians will be supported by the staff of the nursing facilities and our own care coordinators. The ultimate goal of the Integrated Care Program is to improve care coordination via a person-centered, team-oriented delivery system which addresses individual needs.”

“This type of innovative collaboration is essential to the Integrated Care Program,” said Brian K. Stratta, M.D., chief medical officer at IlliniCare Health Plan. “General Medicine’s expertise, along with the support of our skilled care coordination team, will result in unparalleled patient care and improved health outcomes for our members.”

“We are excited to bring our systems, accomplished staff and 30 years of experience to improve care to older adults and adults with disabilities,” said Thomas M. Prose, M.D., MPH, MBA, senior medical director, General Medicine.

General Medicine, P.C. is the nation’s leading post-acute geriatric medical practice. In addition to geriatrics, its group also provides physical medicine and rehabilitation, and medical services for hospital, and long-term care patients. Its physicians and advanced nurse practitioners have achieved national recognition and exposure which set them apart from other post-acute providers. As hospitalists provide specialized care to hospitalized patients, General Medicine provides services exclusively as “On Site” attending Physicians, Medical Directors and Nurse Practitioners for Insurance Company Health Plans; Accountable Care Organizations; hospitals; sub-acute centers; long-term acute care hospitals; skilled nursing and long-term care facilities; residential care and assisted living facilities. Currently, General Medicine serves over 200,000 patients annually in 300+ facility locations throughout the Midwest, the South Central and the Mid-Atlantic States. They also are recognized as leaders in development and providing post-acute services to Accountable Care Organizations, Hospitals and Health Care Systems, and with many national insurance companies.

IlliniCare Health Plan (IlliniCare) is a Managed Care Organization (MCO) contracted to provide services under Illinois’ Integrated Care Program.  IlliniCare is a wholly-owned subsidiary of Centene Corporation, a leading multi-line healthcare enterprise offering both core Medicaid and specialty services.  Information regarding IlliniCare is available via the Internet at www.IlliniCare.com.

Aetna Better Health of Illinois is an Aetna Medicaid company that manages services to Medicaid, Long-Term Care and Aged, Blind and Disabled members.  Our parent company, Aetna, is a leading national company that serves 36.4 million people, including 1.2 million Medicaid members.  Information regarding Aetna Better Health is available via the Internet at www.Aetnabetterhealth.com.

For questions or comments contact James Hershey, General Medicine, P.C., Home Office, 21333 Haggerty Road, Suite 150, Novi, Michigan48375, or call 800-979-9595.  Information regarding General Medicine is available via the Internet at www.Generalmedicine.com.