Improving Care For The Elderly
Under traditional healthcare models, older adults, including those with mobility problems, find their own transportation to a doctor’s office, wait for an hour or so before seeing a doctor, and only spend a few minutes talking with the doctor.
Now, a new healthcare model is emerging where healthcare professionals travel to homes of older adults and the patients have an option of seeing their doctor for a wellness check online rather than in person.
There’s a movement nationwide to improve healthcare for the elderly. Dr. Sachin Jain, president and chief executive officer (CEO) of SCAN Health Plan, describes it as “healthcare on the cusp of a revolution.” SCAN is a nonprofit Medicare Advantage plan with over $2.4 billion in revenues and serves over 215,000 members. If Jain carries out his goals, seniors would have more health services geared toward older adults, more in-home services paid for by insurance plans, and more healthcare technology options.
The move to enhance healthcare for seniors is due, in part, to the Centers for Medicare and Medicaid Services (CMS) expanding supplemental benefits that Medicare Advantage plans are allowed to offer subscribers.
What’s more, CMS and large commercial insurances are reducing barriers to healthcare by offering free or subsidized non-emergency transportation to patients through rideshare companies like Uber and Lyft.
What is also fueling the drive are older adults who want to live independently in their own homes for as long as possible but need help with daily living activities and money for repairs on their home to do so.
A study by researchers at Stanford University School of Medicine found three approaches based on programs around the country, that work well in helping seniors age in place while reducing healthcare spending:
- Social and emotional support from other older adults
- Occupational therapy
- Home repairs and telephone conversations about healthcare goals
While these services are not included in the “traditional definition of medical care,” they can save hundreds of millions to billions of dollars annually, according to the study.
Prior to taking the helm of SCAN, Jain served as president and CEO of CareMore and Aspire Health, both offered through Medicare Advantage plans. While there, Jain diversified CareMore to offer plans to high-risk Medicaid patients and carried out new delivery systems for in-home primary care.
For instance, in 2019, CareMore launched two programs, Primary Care@Home” and “Hospital@Home” which redirected Medicare and Medicaid money into prevention and early intervention services. The programs involved sending a team of health professionals, including nurses, primary care doctors, social workers, and mental health workers to provide in-home services to seniors. CareMore data showed the programs cut hospitalization and emergency visits and readmission rates.
Over at SCAN, Jain said its Independence at Home programs are helping older adults connect to services that ensure that they get their needs met and safely age in place in their homes.
Healthcare Changes Come As Older Adult Population Grows
Plans to improve healthcare for seniors come at a time when the size of the older adult population is projected to increase, not just in the United States, but around the globe.
According to the World Health Organization (WHO), 1 in 5 people globally will be over 60 by 2050, while the world’s population of people over 80 is projected to triple to 426 million in 2050 from 143 million in 2019.
In preparation for the aging population boom, WHO launched an interactive digital healthcare technology tool called the Integrated Care For Older People (ICOPE) Handbook App. According to WHO, the app is designed to improve care for the elderly by providing training and practical guidance to healthcare and social workers on addressing priority health conditions, such as mobility problems, malnutrition, vision and hearing loss, cognitive decline, depression, and other needs of older people.
More Digital Healthcare Options For Seniors
Since seniors are becoming more tech-savvy and are more accepting of health care delivered at home, healthcare organizations want to expand tech options for seniors,
At SCAN, for instance, Jain wants SCAN to partner with tech firms to develop digital solutions and technologies focused on seniors. While at CareMore, Jain said the company provided virtual healthcare for older adults, which came in handy during the coronavirus disease 2019 (COIVD-19) pandemic.
New Care Models Include Social Isolation Prevention
Since the COVID-19 outbreak, assistant living facilities and nursing homes have limited families and friends from visiting residents. Seniors who live independently have pretty much stayed in their homes to reduce their exposure to the virus. As a result, many seniors felt socially isolated.
Before there was a COVID-19 pandemic, senior advocates believed there was a loneliness epidemic among the elderly. Jain said SCAN programs will meet the mental health and social needs of older adults, like those created at CareMore.
While at CareMore, Jain started the CareMore Togetherness program to address loneliness by sending social service and healthcare workers to the seniors’ homes. The home visits met both the health and social needs of seniors.
In a case study of CareMore Togetherness published in The American Journal of Managed Care, one patient said her chronic disease, which she had been dealing with for most of her adult life, kept her from going out and doing things with her friends. Her health compounded her pain of loneliness until she joined the CareMore Togetherness program.
Seniors can expect to see the expansion of other existing programs, such as end-of-life care or hospice, and palliative care, specialized medical care that helps people with serious illnesses feel better by preventing or treating symptoms and side effects of disease and treatment.
With the expected increase in the older adult population comes an opportunity for new approaches to improving not just the physical health of the elderly, but their mental and emotional health, as well. According to Jain, it’s time to “look at new models that think more holistically about patients and their needs.”