2019 Hero MA RoundUp 8.5.19 Medicare

Meeting social needs to improve senior health

Three in four Americans over age 65 suffer from multiple chronic conditions, harming their quality of life and burdening them with high out-of-pocket health expenditures. According to the Centers for Disease Control and Prevention, increased life expectancy and risk factors such as tobacco use and physical inactivity are among the root causes.

Compounding these clinical factors are social ones: Though most older Americans live independent lives, substantial numbers of the aged face other barriers to good health, including access to transportation and proper nutrition. In fact, 24 percent of adults age 65 and older report having two or more unmet social needs. 

Addressing conditions that are driven by social determinants of health – including proper nutrition, access to safe and affordable housing and transportation, as well as access to medical services – can be essential for seniors’ well-being. Recently, the Centers for Medicare & Medicaid Services (CMS) made changes allowing Medicare Advantage plans, which cover nearly 22 million Americans, to offer supplemental benefits to address social determinants of health for members with chronic diseases. 

With this new flexibility, Blue Cross and Blue Shield companies around the country are offering support that goes beyond the four walls of the hospital or doctor’s office by addressing social needs that are important to good health for seniors. Here are some examples:

Tackling food insecurity
There is a direct link between healthy eating and managing and preventing chronic diseases and eating properly after a hospital stay can aid recovery and help eliminate the need for readmission. But for some older adults, financial insecurity, lack of transportation or diminished mobility can hinder good nutrition. Blue Cross Blue Shield of Massachusetts and Independence Blue Cross have joined with community-based meal delivery services to meet the nutritional needs of Medicare Advantage beneficiaries following discharge from the hospital. In addition, members receive nutrition counseling to help them better understand the importance of healthy eating over the long term and the benefits that developing good eating habits can have in managing their chronic conditions.

Bringing primary care where it is needed
To address limited access to primary care in some lower-income neighborhoods, Independence Blue Cross is working with Dedicated Senior Medical Centers to offer a variety of services. With complimentary transportation, on-site lab tests, pharmacy and physicians available 24/7, the centers guide the care of each patient. While the Philadelphia facilities are still new, centers elsewhere have seen patients averaging 33 percent fewer emergency room visits, 28 percent fewer inpatient admissions and 25 percent fewer inpatient hospital days.

Addressing interconnected health needs
Unmet social needs often snowball and can trigger multiple health needs. So, Anthem Blue Cross and Blue Shield’s Medicare Advantage members can choose from a menu of new benefits and supplemental services to address their complex needs. The benefits of Extra Essentials, available in Georgia, Indiana, Kentucky, Missouri, Ohio, Virginia and Wisconsin, include meal delivery; transportation assistance to health-related appointments; a stipend for safety devices, like a shower stool or reaching device; as well as coverage for alternative medical treatments including acupuncture or massage. Benefit choices extend to hiring a personal home helper (also known as a home health aide) or visits to adult day centers.

Overcoming complexity with concierge services
Navigating the health care system can be complicated, but personalized services designed specifically for older beneficiaries are helping remove some of the complexity while improving care. Blue Cross Blue & Shield of Rhode Island, Blue Cross Blue Shield of Michigan (MyBlueSM Concierge) and BlueCross BlueShield of Western New York (Blue Concierge), have developed personalized concierge services to assist members by offering a dedicated point of contact to help them better understand their benefits, find doctors, make appointments and coordinate care. Some concierge services also make recommendations on services and offer educational resources on preventative measures to maintain and improve health.


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