SCAN Health Plan is launching a new care delivery model that it hopes will set a new standard within the Medicare Advantage (MA) space.
A subsidiary of SCAN Group, the Long Beach, California-based SCAN Health Plan announced its new model of care on Wednesday. Moving forward, the model will be made available to all SCAN members enrolled in its “Embrace” Institutional Special Needs Plan (I-SNP).
“U.S. health care is having a ‘Back to the Future’ moment, increasingly moving care delivery to where people live, which usually best suits their needs,” Dr. Payam Parvinchiha, SCAN’s vice president and medical director for integrated care, explained. “With Embrace, we are launching a world-class model that we hope will set a new standard for our industry.”
Founded in 1977, SCAN Health Plan is one of the nation’s largest not-for-profit MA plans, serving more than 220,000 members across its footprint. Traditionally focused on California, the organization recently announced it would be offering new health plans in Arizona and Nevada in 2022.
Generally, I-SNPs are a type of MA plan individuals can sign up for if they meet certain criteria. To be eligible for an I-SNP, enrollees usually have to need institutional-level care for 90 days or more, for instance.
“CMS originally created I-SNP models only for institutional patients who are in nursing homes,” Parvinchiha told Home Health Care News. “But what has happened over time is that a lot of patients who used to live in the nursing home setting are now living in places like assisted living and [elsewhere], where this intensive model of care is more necessary.”
SCAN’s new model of care delivery will be focused on “people who are bound to their homes or reside in skilled nursing or assisted-living facilities,” according to the organization.
It will first be made available to individuals in assisted living, as it’s more difficult to build out the required infrastructure around in-home care.
“The challenge with these models of care is really building out the operations to serve people in these different settings,” Parvinchiha said. “So this definitely can serve patients living in their own homes. We’re building out the capabilities to expand the geographies we could do that in.”
Members enrolled in Embrace will have access to a multidisciplinary team of physicians, nurses, pharmacists, care coordinators, social workers and others. Collaboratively, that team will work to deliver “comprehensive care to members with complex needs,” according to SCAN.
In addition to the frequent visits from clinicians and caregivers from that team, Embrace enrollees will have access to the latest clinical technologies.
Ultimately, the model of care will allow SCAN to deliver care that is typically provided in doctors’ offices and hospitals to individuals wherever they reside, Parvinchiha noted.
“For the most vulnerable patients, we’ve determined that building an integrated model of care where the health plan operations and the clinical delivery are connected and can integrate with one another to deliver the best outcomes,” he said.
Home health providers will likely play an important role in the Embrace concept as well.
“We partner with all elements of health care delivery in the home,” Parvinchiha said. “So home health providers become a key enabler when it comes to addressing care gaps when our physicians and nurse practitioners aren’t able to in certain circumstances.”
Embrace will initially be available to SCAN members in the Los Angeles and Orange County markets.
“Our new Embrace plan and mobile care model is just one example of how SCAN is evolving to deliver on our mission to keep older adults healthy and independent,” Dr. Sachin Jain, president and CEO of SCAN Group and SCAN Health Plan, said in a statement. “By providing care directly to our members where they live, we are better positioned to understand and address their complex medical and social needs.”
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