New Medicare Program Aligns Incentives to Provide Comprehensive Care to High-Needs Patients

Advanced Illness Partners is among 51 entities nationwide designated by CMMI to participate in this new program. Organizations participating in the Model are committed to providing high-value, comprehensive care to high-need Medicare beneficiaries— and are willing to accept risk for the most complex patients in the U.S. healthcare system.
AIP is comprised of seven organizations from six states—Arizona, Florida, Washington D.C., Virginia, Ohio, Nevada and Oregon—which have a combined nearly 250 years of experience in caring for those with advanced chronic illness through largely home-based, community-oriented care. The partners currently serve over 60,000 Medicare beneficiaries annually and have prior success in value-based models such as Independence at Home (IAH), Program for All-Inclusive Care for the Elderly (PACE), and the Medicare Care Choices Model (MCCM).
AIP organizations have provided home-based care in a cost-efficient manner for many years. Now, in light of the COVID-19 pandemic and the consistently stated preferences of many seniors to “age in place,” AIP is excited to show just how effective this model of care can be in meeting patients’ needs.
Eric De Jonge, M.D., Nationally Recognized Geriatrician, Serves as CMO for AIP
Eric De Jonge, Director of Geriatrics at Capital Caring Health and Chief Medical Officer for Advanced Illness Partners, shared, “We’re excited to participate in CMMI’s innovative program to bring advanced illness care upstream and serve patients with complex, chronic disease in the home setting for the long-term. As non-profit providers, our network allows us to remain community-based while also sharing best practices and economies to scale to invest in tools that help us improve care and lower costs of care for high-needs patients.”
The Advanced Illness Partners include Pure Healthcare, a program from Ohio’s Hospice; Geriatric Solutions, a program of the Hospice of the Valley in Arizona; Hope Healthcare in Fort Myers, Florida; Housecall Providers, a part of the CareOregon family; Cornerstone Hospice in Central Florida; Nathan Adelson Hospice in Las Vegas, Nevada and Capital Caring Health in D.C., Maryland and Virginia. All seven organizations are excited to learn from each other and share best practices in treating patients.
Medicare beneficiaries looking for coordinated and comprehensive care may seek to enroll in the new program by visiting AdvancedIllnessPartners.org.
For more information on Advanced Illness Partners or the collaboration, please contact Capital Caring Health’s Director of Population Health, Jacqueline Kimmell, at jkimmell@capitalcaring.org.
The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.
###
About Capital Caring Health
Capital Caring Health is one of the leading nonprofit providers of elder health, hospice, and advanced illness care for persons of all ages in the mid-Atlantic region. A member of a national network of 70 nonprofit hospice providers, our mission is to provide patients and their families with advanced illness care that is second to none. We also have special hospice teams serving children and veterans. On an annual basis, we serve over 7,000 hospice patients and provide more than $3 million in charity care to those who are uninsured and have nowhere else to turn. Almost 90 cents out of every dollar goes to caring for patients and their families.
The website, capitalcaring.org, is available in English, Spanish, and Korean plus offers 24/7 Live Chat. Since the beginning of hospice care over 40 years ago, we have served 120,000 patients and their families in Maryland, Virginia, and the District of Columbia.
24-Hour Care Line: (800) 869-2136
Media Contact: Nancy Cook, VP Marketing, Communications & Public Relations
ncook@capitalcaring.org

Kathleen Ramkaran, RN, CCM
Hali Gantumur
Yasmin
Jennifer Olsen GNP-BC
Dr. Cheryl-Lynne McCalla, DO
Meena Raj, MD,
Catherine McGrady, RN, MSN, is Vice President, Clinical Programs at Capital Caring Health. In this role she is responsible for the development, implementation, and monitoring of clinical programs in support of high-quality patient-centered care delivery across the continuum of services. Catherine also manages external partnerships including Capital Caring Health’s participation in ACOs and other value-based clinical programs
Catherine Kravolec
Sherri Parker
Anne Young
Odessa Simpson
Hope Collazo
LaWanda Middleton
Sally Hughes
Jennifer Godwin
Henry Fuller
Margaret Doherty
Evan Kirschner
Gabby True
Carla Thompson
Shannon Collier
Annette Lindsay
Jason Sobel, MD
Brenan Nierman
Susan Roberts
Jackie Gouline
Stacy Brown
Kremena Bikov


Audrey Easaw
Julia Feldman
Gus has been a part of the Capital Caring Health family for nearly fifteen years. Ten of those years have been in leadership, working with colleagues and co-workers to achieve the best in their ability while promoting CCH core values. Gus has a background in nursing and a lifelong passion for technology. In each position at CCH, Gus has found ways to integrate technology to enhance outcomes and job satisfaction.
Pat Bishop
Elizabeth Ariemma
Joe Murray

Lin Maurano
Dwayne Barton, NP
Jacob Phillips, MD
Tabitha Gingerich, NP
Donna Smith
Paulette Davidson, Chaplain
Colleen Carberry, RN Case Manager
Sherri Parker, Team Leader Medical Social Worker
Steven Skobel’s Story
Marrygold Ugorji’s Story
Sulaiman Bangura’s Story
Neil Parker’s Story
Michael Toohig’s Story
Liberating Europe
Hershell Foster
Hank Willner, M.D.
Laura Branker
Jason Parsons
Altonia Garrett
Kieran Shah
Mandy Brouillard
Sherri Parker
Sayaka Hanada
Caitlin Geary
Heidi Young
Linda Biedrzycki
Heidi Young, M.D.
Jason Sobel, M.D.
Anne Silao-Solomon, M.D.

Mohammad Saleem, M.D.
Maleeha Ruhi, M.D.
Christopher Pile, M.D.
Cameron Muir, M.D.
Fellowship
John McCue, D.O.
Peyman Mamdouhi, D.O.
Adam Knudson, M.D.
Amanda Keerbs, M.D.
Matthew Irwin, M.D., M.S.W.
Alan Goldblatt, M.D.
Jennifer Gerhard, D.O.
Ray Jay Garcia, M.D.
Tamara Barnes, M.D.
Petros
Shaz Anwar, D.O.
Lee-Anne West, M.D.
Melissa McClean, N.P.
Michael Byas-Smith, M.D.
Nancy Cook
Kimberly Grove
Steve Cone
Eric De Jonge, M.D.
David Schwind
Vivian Hsia-Davis
Cameron Muir, M.D.
Keith Everett
Susan Boris
Carolyn Richar
Matt Kestenbaum