By Reneé Buckingham, Segment President of Humana’s Primary Care Organization, including CenterWell Senior Primary Care and Conviva Care Centers
With the Medicare Annual Enrollment Period (AEP) upon us — October 15 through December 7 — it’s the time of year when seniors and their caregivers take stock of their health and healthcare. Are their preferred doctors in their current plan? Are anticipated services covered, such as vision, dental, and hearing? Are the facilities where they receive care in their plan’s network?
While evaluating what’s offered with Traditional Medicare compared with Medicare Advantage plans, seniors should also consider what type of care they will receive next year, as well as in the future when they could have more complex care needs.
Chief among the options is senior-focused primary care, an approach whereby a senior’s physical, mental, and emotional needs are treated more holistically by a team and — equally important — delivered within a stand-alone healthcare center that accepts a range of Medicare Advantage plans.
As the segment president of Humana’s Primary Care Organization, including CenterWell Senior Primary Care and Conviva Care Centers, I see three core groups benefiting most from senior-focused healthcare: seniors, their adult children who often help care for their parents, and physicians. Here’s why.
“While evaluating what’s offered with Traditional Medicare compared with Medicare Advantage plans, seniors should also consider what type of care they will receive, as well as in the future when they could have more complex care needs.”
- Reneé Buckingham
Seniors benefit from specialized healthcare
Primary care for seniors is the first stop toward addressing a range of health issues before they become complicated, difficult to treat, and expensive. According to the National Council on Aging, nearly 70% of seniors are living with two or more chronic conditions, and 25% of older adults experience a behavioral health problem such as depression, anxiety, or substance abuse. Concurrent health issues often result in a web of appointments, paperwork, and medications that can too easily become uncoordinated.
Senior-focused care seeks to eliminate haphazardness and, instead, streamline primary care within a single team in which each team member has responsibility for a select aspect of the patient’s care, but all members share their insights and report into the physician in charge.
A senior-focused healthcare approach is also designed to recognize and address social determinant needs as part of an overall approach to wellness. It has been well-documented that 51% of older adults have at least one unmet social determinant of health need, with even higher percentages for females, Black, Hispanic and rural-based older adults. Take, for example, the case of a CenterWell patient in South Carolina who was unable to control his blood sugar. It wasn’t because he was purposely non-compliant, it was because he could not read or write. This, in turn, affected everything from his financial literacy to transportation, all of which resulted in poor self-care. The CenterWell case manager was able to address each issue, one-by-one, which ultimately ended up in improved blood sugar levels.1
Adult children of aging parents appreciate the support of senior-focused healthcare
Taking care of a senior parent’s healthcare needs can be daunting, particularly for adult children who may live a distance from their aging parents. Not only can organization of the care be a bit overwhelming — with caregivers indicating an overall lack of coordination of services for seniors — but they may not be able to understand fully the range of issues affecting their parent from a distance.
Things like proper nutrition, health literacy, and social isolation are hard to evaluate when you don’t interact with someone daily. Having a senior-focused care team that is responsible for overseeing a range of physical health, mental health, and social needs gives adult children peace of mind that their aging parent is being properly cared for.
Senior-focused care equips physicians with resources to address patient needs properly
Doctors who treat seniors, especially those living with multiple chronic conditions, have identified the need for better coordination of services for their older patients.
For a variety of factors, only 16% of physician practices screen for food insecurity, housing instability, utility needs, and transportation needs, which results in both a frustrated physician and an under-evaluated patient. Surrounding doctors with in-house expertise — social workers, pharmacists and behavioral therapists — who will manage complementary aspects of patients’ health is a welcome relief for doctors who oftentimes recognize the widespread needs of their senior patients, but may not have the resources to address them.
Senior-focused care is further enhanced when backed by a value-based care model, which incentivizes doctors to improve patient outcomes through wellness and preventive care, hallmarks of a team approach.
AEP is critical time of year for all people with Medicare to make decisions that will affect their healthcare. It can no longer simply be an assessment about which doctors are in or out of plans, but rather a consideration of the type of care, setting, and resources that will play a role in their care for the year ahead.