Benzinga | Jun 10, 2021 08:47AM EDT

Upward Health Announces Contract With Clover Health To Serve Patients In Four States Under New Direct Contracting Initiative; Terms Not Disclosed

Upward Health, a leading in-home medical and behavioral primary care provider, today announced a new Preferred Provider relationship with Clover Health, an innovative technology company improving health outcomes for America's seniors, to serve patients with complex medical, behavioral, and social challenges through Clover's in-home primary care program, Clover Home Care. The effort was launched shortly after Clover was identified as a participant in CMS' new Direct Contracting initiative, which is designed to improve healthcare quality and contain costs for beneficiaries with Original Medicare.

As Clover scales Clover Home Care through Direct Contracting, the company has contracted with Upward Health to provide integrated home-based medical and behavioral care for aligned beneficiaries with complex needs in the States of New York, Pennsylvania, Georgia, and Texas.

"We believe Upward Health delivers a truly holistic, integrated home-based model combining medical, behavioral and social support for high risk beneficiaries," said Dr. Kumar Dharmarajan, Chief Scientific Officer of Clover. "Clover is focused on reducing costs through improved health outcomes, and scaling home-based care for our most vulnerable beneficiaries through CMS' Direct Contracting model is a key component of our strategy."

In addition to in-home services, Upward Health offers Facilitated Virtual Care(tm) to expedite access for primary physical, behavioral, urgent and specialty care and to maintain the health of complex patients managing multiple chronic conditions. This enables same-day access to providers for patients who have difficulty getting to a provider's office -- or those who cannot wait for the next available appointment. Facilitated Virtual Care is also available for patients suffering from mental illness and substance use disorders who need expedited psychiatric care or therapy. The company also offers extensive support through field-based personnel for patients struggling with social determinants of health such as food, housing, transportation, and social isolation.

"Upward Health is excited to work with Clover Health and its Participant Providers on this important program" said Glen Moller, CEO of Upward Health. "We are particularly looking forward to providing Clover Home Care patients with integrated primary medical and behavioral care, along with necessary support for social challenges that may hinder their abilities to get well or manage chronic conditions. Our use of the Clover Assistant technology will help ensure that we can provide integrated whole person care in close collaboration with the network of providers supporting patients. We think this will result in better care."

To learn more about the CMS Direct Contracting Initiative, please go to: https://innovation.cms.gov/innovation-models/direct-contracting-model-options