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Slowing Medicare Spending by Optimizing Late-Life Needs

Published June 17, 2020
NEJM Catal Innov Care Deliv 2020;1(4)
DOI: 10.1056/CAT.20.0290
Hero illustration of senior surrounded by the words community, capability, and communication, along with medical symbols.

Abstract

In this article, we highlight three care delivery innovations that could be implemented by Medicare Advantage plans as a late-life care model to better meet the needs of older adults and reduce per capita spending. The elements of this model include (1) community (engaging well-functioning seniors as in-home health workers), (2) capability (improving seniors’ functional capabilities and home environments), and (3) communication (using telemediated behavioral health specialists to help patients articulate their health care goals). We propose that these solutions fall within the scope of the recently expanded Medicare Advantage supplemental benefits, and we estimate that the new care model would offer substantial annual savings for the Medicare Advantage population and individual plans.

Notes

Francesca Rinaldo, Myra Altman, Kendell Cannon, Terry Platchek, Nirav R. Shah, Robert M. Kaplan, PhD, and Arnold Milstein have nothing to disclose.

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Published In

NEJM Catalyst Innovations in Care Delivery

History

Published online: June 17, 2020
Published in issue: July 1, 2020

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Affiliations

Francesca Rinaldo, MD, PhD
Affiliated Scholar, Stanford Clinical Excellence Research Center; Surgical Resident, Department of Surgery, Division of General Surgery, Stanford University School of Medicine
Myra Altman, PhD
Affiliated Scholar, Stanford Clinical Excellence Research Center
Kendell Cannon, MD
Affiliated Scholar, Stanford Clinical Excellence Research Center; Clinical Assistant Professor, Medicine – Primary Care and Population Health, Stanford University School of Medicine
Terry Platchek, MD
Director, Stanford Clinical Excellence Research Center Healthcare Design Fellowship; Clinical Associate Professor Pediatrics, Medicine – Primary Care and Population Health, Emergency Medicine, Stanford University School of Medicine
Nirav R. Shah, MD, MPH
Senior Scholar, Stanford Clinical Excellence Research Center; Adjunct Professor, Medicine – Primary Care and Population Health, Stanford University School of Medicine
Adjunct Professor, Medicine – Primary Care and Population Health, Stanford University School of Medicine
Arnold Milstein, MD, MPH
Director, Stanford Clinical Excellence Research Center; Professor, Medicine – Primary Care and Population Health, Stanford University School of Medicine

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