Before Evercare can do business in any state, its provider network has to be approved by CMS or the state.  In addition, hiring and training an integrated team fully capable of overseeing patients takes about six to nine months.  At the end of the six to nine month period, new hires are required to have a strong knowledge base in geriatrics and chronic condition management.  Additionally, a Medical Director and a clinical manager who is a subject matter expert must be in place to support the frontline staff.

Evercare looks for NPs and CMs with geriatric experience and/or management of long-term conditions.  Individuals seeking employment need to be autonomous and comfortable working independently and have demonstrated strong communication skills.

Evercare has developed a “College of Clinical Development” to ensure the development of their staff.  The College provides a very intensive orientation process that may last for six months to a year depending on the new hire’s background.  The core of the program is housed on a computer system, through which new hires can attend webinars and take specific courses.  In addition, each new hire is assigned a mentor to provide direct assistance with the development of specific skills and to ensure the achievement of specified competencies needed to meet the needs of the population served.  Evercare has developed competency assessment tools for both CMs and NPs and has a standard for the design and implementation of individual-specific development plans.

Enrollment in any of the health plan offering will be unique to the plan since Medicare allows for self-selection (an individual chooses to enroll), as opposed to some Medicaid-only plans where there is a state driven enrollment process.

Evercare now offers Medicare Advantage Special Needs Plans and/or Medicaid plans to 190,000 members in 38 states.

The Evercare Care Model has enjoyed the support of UnitedHealth Group, which is one of the largest health care plans in the nation, from its inception.  It would be quite difficult for an organization to replicate the full model at the same scale as Evercare; however, various pieces of this model (e.g. technology, information systems, capitation structure) could be adopted for use by other organizations.