By Reneé Buckingham, segment president of Humana’s Primary Care Organization, including CenterWell Senior Primary Care and Conviva Care Solutions, and Vivek Garg, M.D., Chief Medical Officer of Humana’s Primary Care Organization.
Undoubtedly, the growth of the senior population now and in the decades ahead will drive greater use of healthcare services for this population. This, in turn, requires better coordination of — and improved access to — comprehensive care that is particularly suited toward seniors.
To achieve this, we need to offer one-stop care that is manageable for seniors, especially those residing in underserved areas.
This is where senior-focused primary healthcare comes in. It’s a model whereby a senior’s physical, mental, and emotional needs are treated holistically by a team and — equally important — delivered within a stand-alone healthcare center that accepts a range of Medicare Advantage plans.
As we see it, there are three critical characteristics of senior-focused primary care.
It’s different from the traditional doctor’s office experience.
Seniors have unique clinical needs when compared to the rest of the population, and senior-focused primary care offers a holistic approach that takes those unique needs into consideration. For example, CenterWell and Conviva use a “care team” approach, meaning that the patient has access to a physician, nurse, social worker, pharmacist and behavioral therapist who, together, monitor for and address factors that can have a major impact on the health of seniors. The team will assess whether the senior patient has access to good food, proper housing, and transportation; if they are taking their prescribed medications; and the extent to which they may be lonely or depressed.
“Seniors have unique clinical needs when compared to the rest of the population, and senior-focused primary care offers a holistic approach that takes those unique needs into consideration.”
Vivek Garg, M.D.
Further, our physicians spend more time with each patient than traditional fee-for-service practices do — averaging 40 minutes per visit, rather than the usual 15 to 20.
It’s best delivered as part of value-based care model as opposed to fee-for-service.
Many payers are moving toward a value-based care approach — one that pays doctors based on overall health outcomes, rather than the traditional, transactional “fee for service” model of healthcare in which a patient is treated for one specific condition at a time. A value-based approach promises more individualized care that is also more preventive.
This approach works best when paired with Medicare Advantage plans, which cover most of the patients in senior-focused primary care settings. This pairing allows alignment on what matters most to patients, commitment to personalization and partnership in the management of the very complex challenges these patients face. The intentional focus on prevention and quality care helps make health care more affordable by incentivizing cost effectiveness.
It’s designed to work in tandem with specialists.
Care teams within a senior-focused primary care setting pay special attention to coordinating the care of seniors, oftentimes playing a managerial role in the process. Rather than simply handing the patient a list of possible providers, teams will help schedule the specialist visit, and then schedule a follow-up visit.
This not only alleviates burden on the patient, but also allows the primary care provider to remain in the loop on any directives from the specialist.
“The benefits of senior-focused primary care — its integration with a team approach, focus on a value-based care model, and coordination of specialty care — collectively lay the groundwork for improved health for our seniors now and in the future.”
The benefits of senior-focused primary care — its integration with a team approach, focus on a value-based care model, and coordination of specialty care — collectively lay the groundwork for improved health for our seniors now and in the future.