Benzinga | Jun 9, 2021 09:07AM EDT

Spiras Health Reports 5-Year Deal With Clover Health To Provide Complex Car Mgmt. Services To Medicare Members In Kansasa, New Jersey

Agreement Will Provide Complex Care Management and Care Delivery Services to Some of the Most Vulnerable Patients as Clover Scales Its In-Home Primary Care Program

NASHVILLE, Tenn.--(BUSINESS WIRE)-- Spiras Health today announced a five-year agreement with Clover Health, an innovative technology company improving health outcomes for America's seniors, to provide complex care management services to Medicare members in Kansas and New Jersey. The value-based contract will provide Spiras Health's personalized multi-modal approach to some of Clover's most vulnerable patients.

As Clover scales Clover Home Care, its in-home primary care program for medically complex and homebound members, through the U.S. Centers for Medicare and Medicaid Services' (CMS) new Direct Contracting model, Spiras Health will support the growing number of Clover-aligned beneficiaries with complex chronic conditions with its unique model that includes home-based services, virtual care and remote patient monitoring at no cost to patients. A dedicated clinical team will provide eligible individuals with in-home, virtual and telephonic visits to promote treatment compliance, identify social determinants that may impact their health, and support the patients' physicians and care teams.

"Spiras Health and Clover Health share a commitment to addressing the needs of patients with complex chronic conditions with a unique and specialized home-based approach focused on improving the patient's health and quality of life while reducing costs," said Scott A. Bowers, CEO, Spiras Health. "We are excited to work with Clover Health's technology platform and provider network to bring a value-based approach to their most vulnerable patients right in their own homes."

Within the new Direct Contracting program from CMS, Clover will use its proprietary platform, the Clover Assistant, to proactively identify fee-for-service Medicare patients with complex chronic conditions who are eligible for Clover Home Care and may benefit from Spiras Health's high-touch individualized delivery model. Spiras' Clinical Care Teams, led by an Advanced Care Nurse Practitioner and including state-licensed nurses, respiratory therapists, and other allied health professionals, work with each patient's physician to diagnose, treat, educate, and engage the patient in self-care.

"As Clover scales Clover Home Care, we'll be searching for like-minded partners. We believe Spiras Health has the right combination of home-based and virtual support to help address multiple issues that contribute to poor health outcomes and high utilization of care for patients with complex chronic conditions," said Kumar Dharmarajan, Chief Scientific Officer of Clover. "Many of these patients are frequently hospitalized or in the ER with exacerbations that could be prevented. With the help of Spiras Health, we look forward to scaling our in-home primary care program to bring a high level of complex care management to the fee-for-service Medicare population."