Today’s American workers are paying into Medicare every paycheck over the course of 30-40 years, in anticipation of tapping this resource for their healthcare needs in retirement. Once they reach this point, at least 30 percent of Medicare beneficiaries elect to get their benefits through private health plans participating in Medicare Advantage, according to the Kaiser Family Foundation. And that number is growing as seniors seek the quality of care and service they typically enjoyed prior to their Medicare eligibility.
Given the US healthcare system’s inefficiencies and poor clinical outcomes, as well as the cost of caring for the nation’s frail and chronically ill senior population, is it possible for health plans, government programs, and the medical community to come together and provide the holy trinity of easy access, quality care, and exceptional service? Those who become Medicare-eligible certainly expect it and arguably deserve it, but is it realistic?
Many traditional companies in the Medicare Advantage space, as well as a burgeoning number of industry disruptors, such as Samsung and Google, claim to have the answer, but they often fall short in one or more areas. Why? Because they focus on benefits and features, rather than on what really matters: solving what is broken in the delivery of quality and efficient care while improving seniors’ total healthcare experience.
Concierge Services for Seniors
“Concierge,” a term defined in part by the Oxford Dictionary as someone “whose job is to assist guests,” is now more broadly used as the delivery of exceptional consumer experience. Healthcare has even carved out a niche called “concierge medicine,” a delivery system where a patient pays for enhanced care by a doctor, including immediate access and quality time.
The notion that one could get concierge care as a senior on Medicare at no additional cost perhaps seems incongruous and impractical. Nonetheless, we at Alignment Healthcare have found opportunities to do just this, such as providing our members with:
- A personal concierge team that includes day and night access to resources such as a doctor through a dedicated phone line and mobile app. Whether the call is for urgent medical intervention, health-related questions, a timely specialist appointment or assistance ordering adult diapers at 2 AM, patients’ problems can be addressed on a single call.
- A clinical delivery system that enables members to access care in a doctor’s office, in a clinic setting, over the phone, online, or for chronically ill members, at home, which is particularly important for those with debilitating conditions.
- Treatment plans that are proactive, not reactive. Through technology that synthesizes disparate sources of clinical and socioeconomic information about our patient population, our doctors and concierge team can review individual patient health data and identify critical gaps in care – a missed mammogram appointment, for example – and proactively intervene to mitigate health risks. Monitoring the vital signs of many chronically ill patients remotely in real time, provides quick intervention to address situations before they become more serious issues. Predictive modeling and artificial intelligence can help prevent or minimize the impact of chronic conditions.
- Extended support: Looking beyond the confines of members’ healthcare delivery to address social and environmental needs can impact health and recovery. For example, an older adult discharged from the hospital may not have the ability to shop for food or prepare his meals. One way to assist patients in this way is to offer meal delivery service after hospitalization to ensure proper nutrition supports better recovery and health outcomes.
- Special perks: Rewarding patients for making good health choices and behaviors, such as having a colonoscopy or getting an annual flu shot, goes a long way. Convenience also helps – such as providing a special access card – a debit card essentially, automatically loaded with the member’s benefit allowance every month. Members with that benefit can use that card at more than 50,000 retail outlets like CVS and Walmart to purchase over-the-counter health-related items.
Traditional companies and disruptors alike claim to be transforming the way healthcare is delivered, but few offer a truly differentiated clinical care or consumer experience. They start from a position focused on services, features, benefits and then market those to the customer.
Success requires a completely different point of view: Deliver an exceptional healthcare experience at every point of connection, using a system where the senior and his or her needs are at the center, and the products and services are designed to meet those needs – and then exceed their expectations in the delivery. The trinity of easy access, quality care, and exceptional service is indeed realistic. Now that’s transformative healthcare.