Medco and Coventry plan preventive care study

AP News
Posted: Dec 01, 2009 4:56 PM

Medco Health Solutions Inc. and Coventry Health Care Inc. said Tuesday they will work together to see if they can reduce health care costs for senior citizens by addressing factors like home safety, diet and medication use.

The companies say they will conduct a study to determine if they can reduce hospitalizations for seniors on Medicare. Teams of Coventry and Medco employees will identify patients who are at the most risk for hospitalization, and work with their physicians and other agencies to find factors that can cause poor health, and they will keep in touch with patients through regular visits and phone calls.

Medco, of Franklin Lakes, N.J., is the largest U.S. pharmacy benefits manager, and handles drug benefits for plan sponsors and members. Coventry, which is based in Bethesda, Md., is a health insurer. Medco handles Coventry's Medicare business, and starting next year, Medco will manage prescriptions for Coventry's commercial insurance and workers' compensation businesses.

The study will include about 2,150 seniors in the St. Louis and Kansas City, Mo., areas on Coventry's Advantra Medicare Advantage Plan. After a year, the rates of hospitalization for the study patients will be compared with other seniors enrolled in the Advantra plan.

The companies said rates of hospitalization for seniors over 65 is increasing, and that population is the most at risk for chronic ailments like diabetes and heart disease. Medco makes money by helping plan sponsors reduce costs, and Coventry, like other health insurers, has struggled recently with rising medical expenses.

Medco said it is focusing on preventive care, and noted it is involved in a similar collaboration with Healthways Inc., a provider of diabetes treatment programs and other health services. Medco said its pharmacists are teaming with Healthways nurses and health coaches to help newly diagnosed patients deal with chronic conditions.

St. Louis and Kansas City were chosen for the study due to the number of Medicare members, and the similar demographics and health issues of the two cities.