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Catching Up On Important Care For Older Americans Amid COVID-19

posted by Devin Plote, Clinical Policy Analyst, AHIP

on May 5, 2021

Skipping or delaying care can have serious health consequences for seniors.

The beginning of the COVID-19 crisis delayed many older Americans from seeking or receiving important preventive and routine health care services in order to avoid unnecessary exposure to the virus, and to preserve the health care system for patients who became seriously ill and required hospitalization. Data shows that during the first months of the crisis:

  • 1 in 6 older adults (70+) delayed or canceled essential medical treatment,
  • Almost 40% put off non-essential treatment, and
  • A third went without preventive care.

By missing regular care to avoid potential COVID-19 exposure, older Americans with chronic conditions including cancer, heart disease, depression, and mental health issues may face greater risk for complications from those conditions—unrelated to COVID-19.

Among Medicare beneficiaries who have foregone medical care during the pandemic, 43% reported missing dental care; 36% missed their regular checkups; 36% delayed treatment for ongoing conditions; 32% delayed diagnostic or medical screening tests; 24% waited longer to seek vision care; and 17% delayed surgeries. Delays in routine cancer screenings, particularly mammograms, have resulted in delayed and later-stage diagnoses that may result in higher mortality rates, The Wall Street Journal reported. And 57% of those who delayed care said they experienced negative health consequences, according to a study conducted by the Harvard T.H. Chan School of Public Health, the Robert Wood Johnson Foundation, and the National Public Radio.

Fear of COVID-19 exposure kept many people away from their health care providers for weeks or months. Notably, the primary barriers to care included being unable to get an appointment, finding a physician who would see them, or difficulty in safely accessing the care site.

Health insurance providers are encouraging their members, particularly older people, to get their preventive screenings, routine care, and chronic condition management despite the COVID-19 pandemic.

  • Bright Health makes non-emergency transportation available for all members, and ride limits are being waived for non-emergency visits to and from their doctor.
  • Priority Health has partnered with technology company Papa to connect college students with Medicare members with specific chronic conditions who need assistance with transportation, house chores, technology lessons, companionship, and other senior services.
  • Humana mailed more than 1 million in-home preventive screening kits to members in 2020, helping increase access to routine screenings that many members have put off during the COVID-19 crisis. Humana also waived telemedicine costs for all urgent care and allowed early refills on regular prescription medications.

Health insurance providers know that many Americans are homebound, or rely on caregivers and family members to manage their health, even under normal conditions. Plans are playing a leadership role in helping provide emotional support to members, their families and caregivers, and making sure individuals and caregivers have access to peer coaches and support specialists with information on social services.  For example, upstate New York health plan CDPHP uses video visits to keep family members informed about a loved one’s care and to provide emotional support, in the absence of in-person visits.

In addition to supporting their members in getting routine care, health insurance providers are helping to vaccinate homebound Americans against COVID-19:

  • BlueCare Tennessee connected with provider partners and local emergency services to send nurses, emergency medical personnel, or mobile vaccination vans to areas with a high concentration of homebound members. Members and their family were vaccinated in their homes if they were eligible.
  • The Commonwealth of Massachusetts partnered with the Commonwealth Care Alliance (CCA) to serve as the vaccine coordinator for the Massachusetts homebound population. CCA manages a technological, logistical, and provider infrastructure to receive referrals of state-screened homebound residents for outreach and appointment scheduling, vaccine distribution, delivery of vaccines to people’s homes, and reporting on their performance.
  • HealthPartners has collaborated with 10 health systems across Minnesota to coordinate efforts to distribute and administer vaccines, leveraging HealthPartners’ home health subsidiary to offer vaccines in people’s homes.

As the COVID-19 crisis disrupted lives and livelihoods, it also worsened health disparities and access to care for vulnerable populations. Seniors are particularly vulnerable in the socially distant world, and we all have to continue to adapt to ensure that no one is left behind.