Health Plans - COPC Senior Care Advantage

Central Ohio Primary Care has been on a population health journey over the past few years and this program has been built off our experience and success as we transition, as many practices must, to value-based care. Working in partnership with locally operated Medicare Advantage plans, the program was launched on January 1, 2018 enrolling Medicare Advantage (MA) members that are cared for by a COPC primary care physician. The contracted Medicare Advantage plans for 2022 are:

Aetna
Anthem
Humana
MediGold

For this program, certain clinical and administrative services historically administered by the health plan will be provided by the COPC Senior Care Advantage team.

COPC Senior Care Advantage and How It Works

COPC care management and disease management programs will enhance programs historically provided by the health plan and will be integrated into the medical care provided by COPC and the consulting specialists, where appropriate.

Network provider contracting will be performed for this program when requested by a participating health plan.
Utilization management and provider credentialing will now be coordinated through COPC Senior Care Advantage.
When requested by the health plan, COPC Senior Care Advantage will also process and pay claims for all healthcare services provided to patients. Access to claims data will provide the COPC medical team more information on quality, cost and transparency to better care and manage their patients.
COPC Senior Care Advantage provides educational sessions throughout the year for COPC patients to learn more about the benefits of Medicare Advantage plans and the benefits of joining the Senior Care Advantage program. Events are developed and held jointly with current and potential partners.
Patients who select an HMO plan for their Medicare coverage must select a COPC primary care physician in order to participate in the COPC Senior Care Advantage program. This PCP election should be made at the time of enrollment. All patients electing Medicare Advantage coverage, regardless of whether it is through a HMO or PPO plan are encouraged to see their COPC primary care physician for their annual wellness visit as soon as possible. Not only do patients receive a complimentary gift, but the annual wellness visit is the best way for seniors to develop their wellness plan in collaboration with their COPC physician. For a full list of COPC physicians and office locations, please click here.

How COPC Senior Care Advantage Program Will Benefit Patients

The COPC Senior Care Advantage program was designed by COPC physicians based on their vision that seamless and greater coordination of care was required to optimally care for their senior patients. The goal is to help patients maintain their best level of health and enjoyment of life.

The program will include many benefits to seniors including:

A comprehensive wellness exam will be performed annually for all COPC Senior Care Advantage patients to ensure a complete, accurate and updated assessment of the patient’s medical conditions, lifestyle and social support needs.
Enrollment in COPC Senior Care Advantage disease management and education programs for diabetes and COPD. See the Unique Model of Care section of this website for more information on those programs.
Concierge service for patients who are hospitalized and need guidance and planning for a safe, smooth transition back home.
To promote the importance of the annual wellness exam, as a critical component of care, they will receive a complimentary gift.

To provide full oversight of the patient’s care, referral authorizations and utilization management decisions will be guided and managed by COPC physicians for the COPC Senior Care Advantage program, not insurance company representatives for most participating plans.

Working Together With Medicare advisors, Licensed Agents, Health Plan Representatives

The COPC Senior Care Advantage leadership team welcomes collaboration with Medicare advisors, licensed agents, and health plan representatives to ensure that COPC patients are aware and have access to resources to understand the benefits of enrolling in the program. We are developing educational tools for you to use when you discuss Medicare coverage options with your clients who are also COPC patients.

If you or your organization would like to collaborate with us, please contact us at MedicareInfo@COPCAdvantage.com.

We will also be providing sponsorship and collaboration opportunities for interested sales partners. If you would like to be included on our contact list to receive notifications of special events, collaboration opportunities and downloadable resources, please send us an email with your contact information to MedicareInfo@COPCAdvantage.com.