By EMILY HAILE, Capital News Service
WASHINGTON - Rufus "Lee" Arrington's mailbox used to be full of solicitations from Medicare health plans promising benefits that always seemed too good to be true.
But this year, the 66-year-old salesman from Baltimore says he may have found his dream plan—Care Improvement Plus, Maryland's first health plan for Medicare patients with chronic illnesses.
"I just walk into the doctor and they take care of me and I go," he said. "I'm relieved. I like it."
Created with the looming, baby boomer health care problem in mind, Care Improvement Plus' goal is to cut costs by focusing on prevention. Such programs are a relatively new phenomenon, established through the Medicare Modernization Act of 2003 that created specialized plans with tailored services focusing on disease management for diabetes, heart failure, pulmonary or renal disease, and other chronic problems.
At least 98,000 Marylanders are eligible, and about 500 have enrolled since the program launched early this year.
Started by a group of physicians, Care Improvement Plus is administered by Baltimore-based XLHealth and has expanded in Maryland to include Anne Arundel, Baltimore, Calvert, Carroll, Charles, Harford, Howard, Montgomery, Prince George's and St. Mary's Counties. It requires no co-payments or premiums and members may use any Medicare provider.
It's also been launched in five other states: Texas, Arkansas, Missouri, Georgia and South Carolina.
It turns out diagnosing complications before they become serious isn't just good for seniors' health. It's also good business.
"It's going to save money," said Care Improvement Plus spokeswoman Kristin Brunnworth. "It's all about prevention."
The medical costs of people with chronic diseases account for more than 75 percent of the nation's $1.4 trillion medical bill, according to the Centers for Disease Control and Prevention.
In four years, the company's programs have helped cut heart bypass surgery rates by nearly 60 percent and amputation rates by more than 50 percent, according to XLHealth.
Diabetics need to check their feet for proper circulation or possible infection, or they risk amputation, said Brunnworth. By offering consultations with podiatrists and special shoes for diabetics, the plan is anticipating potential problems down the road.
Arrington, who worked for 17 years as a laborer and packaging supervisor at McCormick & Co. Inc., has several serious conditions including high blood pressure, Type 2 diabetes and heart problems.
The plan has taken away a lot of the worry and guesswork about caring for himself.
Each member is provided with a health care manager, a field nurse and a telephone coach. They work as a team to coordinate appointments and care.
"If they're willing to help me, I certainly have to help myself," said Arrington. "They make sure that I'm on the right track."
Now, Arrington takes his blood pressure two to three times a day and doesn't go off his medications like he used to.
Taking six medications—he pays $24 per prescription, less than half their former cost—and regular doctors' visits used to get him down, but lately Arrington feels more hopeful.
He's exercising more, getting up at 6 a.m. to take walks.
"I'm looking forward to getting up and getting started the next day," he said.
Arrington has plenty to keep him busy. He works part time as a used car salesman at Antwerpen Hyundai in Catonsville. On days off, he putters around the house with his wife or makes hot dogs for his seven grandchildren.
Since joining the plan, Arrington has a lot more confidence, said Joyce Deloris Arrington, his wife of 47 years.
"He's a worry-wart, and I think it put his mind at ease."