Carelon Health information

Carelon Health, (formerly CareMore) a subsidiary of Elevance Health through its Carelon brand, is an integrated health plan and care delivery system for Medicare and Medicaid patients. The company was founded in 1992 as CareMore by Sheldon Zinberg and Johnn Edelston, President of HealthPro Associates through the merger of Community IPA managed by HealthPro Associates and Internal Medicine Specialists Medical Group, managed by Dr. Zinberg. It was based on the Sac-Sierra Medical Clinic structure of a "clinic without walls". CareMore was structured as a partnership of corporations with a wrap-around IPA. The ownership included 33 mostly independent primary care physicians as a small Southern California regional medical partnership. the company was rebranded as Carelon Health in 2024. Today, Carelon Health serves 125,000 patients across 9 states with annual revenues of $1.2B.^[1]

The company has developed a care model designed to target high-risk, chronically ill patients through focused care coordination, patient education, and proactive disease management. This model has resulted in costs 18% below industry average,^[2] while tangibly increasing quality: hospital admissions are 42% below national average,^[3] average length of stay is 32% below traditional Medicare Fee-For-Service (FFS), and diabetic amputation rates are 67% below traditional FFS.^[4] These results have led some health policy experts to point to CareMore as one of the most innovative models to reform Medicare. However, CareMore has also been criticized as a one-off success story that will not be able to scale beyond its core markets.