posted by AHIP
on September 9, 2019
The U.S. health care system spends a lot on medical care for seniors, who are living longer and may need more care as they age. To help aging seniors live active and healthy lives, health insurance providers have moved beyond traditional medical care to connect members to community-based resources that encourage healthy behavior changes, such as better nutrition and exercise or quitting smoking.
By 2030, Americans over the age of 65 are expected to top 74 million, representing 21% of the total U.S. population. Health care spending for aging seniors is often cited as one of the largest costs across the health care system. The National Council on Aging reports that approximately 92% of older adults have at least one chronic disease like heart disease, cancer or diabetes, and 77% have at least two. Obesity alone, which can lead to stroke, type 2 diabetes, and heart disease, costs the United States $147 billion and this figure is expected to increase by at least $48 billion annually by 2030.
September is Healthy Aging Month, so let’s look at some of the ways health insurance providers are improving seniors’ quality of life:
Alignment Healthcare has established 20 senior-focused clinics in California, North Carolina, and Florida that feature a technology-enabled, patient-centered model of care focused on reducing hospitalizations and improving health outcomes for Medicare Advantage members. The clinics have been designed to provide personalized, comprehensive disease management programs for chronic conditions, as well as wound care. For example, Alignment leverages remote monitoring kits for patients who may need additional care or oversight while at home. These tablets send biometric information directly to Alignment’s command center, automatically alerting the care team to issues such as low blood sugar or sudden weight change. In California, seniors saw 50% fewer hospital admissions in 2015 and 38% fewer emergency room visits than before enrolling in Alignment’s home-monitoring program.
Anthem has partnered with SilverSneakers to offer free fitness programs to members in many of their Medicare Advantage and Medicare Supplement plans at no additional cost. SilverSneakers offers a variety of fitness classes to accommodate all levels and preferences. The program offers access to more than 14,000 fitness and wellness facilities nationwide. Beyond addressing an opportunity to improve physical activity, SilverSneakers also aims to provide more opportunities for seniors to engage in social activities.
Fallon Health’s NaviCare program provides coordinated medical, prescription, and support care for seniors who are 65 and older, live in the service area, and are eligible for MassHealth Standard, the Massachusetts Medicaid program. NaviCare members have a team of experts dedicated to coordinating a personalized, in-home care plan. Members receive assistance with bathing, dressing, and meal preparation, as well as access to social support systems, such as a social transportation benefit that helps them remain active and engaged in family and community activities. Seniors like the NaviCare program, giving it a satisfaction rate of more than 97%. Moreover, NaviCare enrollees have fewer acute hospital admissions than traditional Medicare fee-for-service beneficiaries and spend fewer days at Skilled Nursing Facilities, so they have more time at home with loved ones.