From Pilot to Program: Florida Blue Expands Cancer Support for Medicare Advantage Members

As part of its ongoing commitment to members with cancer and their families, Florida Blue, the state's leading health insurer, has launched a new care navigation program. The program guides patients throughout the cancer journey, providing a better experience that connects them to the care and support they need. A pilot study showed a successful 40% reduction in hospital and ER visits for participating patients.

Florida Blue introduced this comprehensive solution for its Medicare Advantage members in collaboration with Evolent, an independent company focused on helping people with complex conditions get the care they need. At no additional cost, patients get a dedicated care navigator and access to easy-to-use digital tools, providing them with ongoing support and guidance between doctor's visits. Early results show improved outcomes and lower health care costs, with a high patient and caregivers satisfaction score of 95%.

Care navigation can help patients manage the often overwhelming realities that come with a cancer diagnosis, and it's particularly valuable in older adults. Cancer rates increase with age, and many older Americans also face social isolation. According to 2022 U.S. Census data, 28% of people 65 and older live alone and do not have children, making it more difficult to navigate cancer care without a built-in support system. In Florida, more than 1.1 million older adults were living alone as of 2023, according to the Florida Department of Health.

Florida Blue and Evolent have worked together since 2021 to improve cancer care for members. Adding care navigation builds on the collaboration by creating a more tailored, higher quality experience. Patients are paired with an Evolent care navigator for personalized guidance including help coordinating appointments, managing symptoms and side effects, planning for emergencies, and connecting to community resources such as support groups.

"We're committed to supporting our members when they're well and through challenging times," said Dr. Thomas Graf, chief medical officer of Florida Blue Medicare. "This innovative approach helps members and their families better manage their cancer care, with greater confidence and clarity, so they can focus on their health, loved ones, and quality of life."

The program also uses a digital platform called Careology to facilitate collaboration between members, caregivers, and clinicians. Through Careology, patients can track symptoms, set reminders for appointments and medications, share real-time updates with their care team, and get advice outside of their office visits. By bridging the gap between clinic and home, this platform ensures members receive timely, personalized support and care, even when they're not in a clinical setting. This continuous connection helps navigators identify problems earlier and ensures members receive the care they need, when they need it.

"By giving clinicians real-time insights into a patient's experience, we can help them make better decisions and provide more effective care," said Dr. Von Nguyen, Evolent's chief medical officer. "This improves patient outcomes and enhances the overall care experience for patients and their families."

For more information about Florida Blue's care programs, visit the care programs webpage for Medicare members.

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About Florida Blue Medicare

Florida Blue Medicare is committed to helping our Florida neighbors live healthier. Florida Blue Medicare offers a wide range of plan options, including Medicare Advantage plans, to give Florida's Medicare-eligible population what they need to live their best lives and improve their overall health and well-being. Headquartered in Jacksonville, Fla., Florida Blue Medicare is proud to be affiliated with Florida Blue, a health insurer that has served Floridians for 80 years. Florida Blue and Florida Blue Medicare are Independent Licensees of the Blue Cross and Blue Shield Association. Florida Blue is a trade name of Blue Cross and Blue Shield of Florida, Inc. Learn more at FloridaBlue.com/Medicare.

About Evolent

Evolent (NYSE: EVH) specializes in better health outcomes for people with complex conditions through proven solutions that make health care simpler and more affordable. Evolent serves a national base of leading payers and providers and is consistently recognized as a top place to work in health care nationally. Learn more about how Evolent is changing the way health care is delivered by visiting evolent.com.