Home   Contact   Careers   Partners & Related Links   Care Improvement Plus

•   Press Releases
•   Executive Bios
•   Corporate Background
•   Media Contact

Home >> Newsroom >>   Corporate Background

Company Background

Founded in 1997, XLHealth has a proud history as an industry leader in improving the quality of care and reducing the cost of healthcare for chronically ill seniors through disease management services. Over the past three years, the company has evolved from an outsourced provider of disease management services to become the owner and operator of Care Improvement Plus, one of the nation’s largest chronic condition Special Needs Plans (C-SNP) -- disease management-focused health plans offered to Medicare beneficiaries with chronic illnesses such as diabetes and heart failure.

XLHealth has been at the forefront of disease management innovations since its inception. Founded by a group of physicians and business executives , XLHealth’s unique approach to disease management has resulted in positive healthcare outcomes while lowering healthcare costs.

XLHealth’s disease management model goes beyond the more customary approach of telephone or direct mail communications with patients. The company’s approach is based upon the belief that one of the best ways to assess a patient’s condition is to have medical personnel conduct evaluations in person. The company is a recognized pioneer in its delivery of disease management services in a personal, “high touch” way that supports physicians in increasing the quality of care for their patients and eliminating unnecessary barriers to preventive treatment.

XLHealth disease management emphasizes the critical importance of the role physicians have in the health care equation. In fact, the premise upon which XLHealth is predicated is that disease management and support programs are most effective when they establish strong ties with the local healthcare community.

In 2003, the United States Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS) awarded XLHealth one of three demonstration projects in the nation to test whether disease management will improve the care of chronically ill Medicare patients. Within the program’s first year, XLHealth successfully recruited and provided disease management services to approximately 10,000 participating Medicare beneficiaries.

In 2004, CMS selected XLHealth to administer the Medicare Health Support pilot program in Tennessee, a major initiative to help improve the quality of care for chronically ill beneficiaries under the Medicare fee for service program. Through Medicare Health Support, XLHealth is responsible for recruiting and providing health support services to approximately 20,000 Medicare fee-for-service beneficiaries with diabetes and/or heart failure.

In 2006, XLHealth launched Care Improvement Plus, a Medicare Advantage plan focusing on the unique healthcare needs of Medicare beneficiaries with diabetes, heart failure, end-stage renal disease and/or chronic obstructive pulmonary disease. Approximately 1.3 million Medicare beneficiaries in Arkansas, Georgia, Maryland, Missouri, South Carolina and Texas are eligible to join the plan, which combines traditional Medicare coverage with disease management services, a Medicare Part D drug benefit and medication management services. Since its initial launch, Care Improvement Plus has grown to become XLHealth’s core business focus, with over 70,000 chronically ill members.

In August of 2007, XLHealth completed a $290 million private placement, with funding provided by MatlinPatterson Global Opportunities Partners III L.P., and MatlinPatterson Global Opportunities Partners (Cayman) III L.P., investment partnerships managed by MatlinPatterson Global Advisors LLC, a private equity firm. GS Capital Partners, LP, the private equity arm of Goldman, Sachs & Co. which helped fund the company’s growth in 2005, continues as an investor of XLHealth.

As part of the transaction, XLHealth acquired Leprechaun, LLC the market leader in outsourced revenue and coding management for Medicare Advantage plans, offering technology and consulting services designed to improve efficiencies in Medicare Advantage plan member assessment, diagnosis, data management and claims management. Leprechaun’s informatics and sophisticated predictive modeling tools identify incomplete or inaccurate diagnostic and treatment coding for Medicare Advantage plan members, resulting in greater accuracy in the information required to successfully manage revenue claims coding data and correlating risk adjusted payments.

XLHealth continues to evolve as a key participant in Medicare’s renewed focus on the approximately nine million participating beneficiaries with chronic illness. Based on the company’s experience as a disease management company focused on the needs of seniors with chronic illness, XLHealth expects to continue to reduce hospitalizations by improving the quality of care for the Medicare lives it manages.