Facing a ‘boomer’ of change, Medicare gets personal

You might call Paul Schuster a typical baby boomer — someone who values his independence and wants to chart his own course.

Despite encouragement from his wife, Judy Schuster, to get a checkup, Paul Schuster avoided going to the doctor for many years. “I didn’t feel I needed to. I felt all right.”

“He always had an excuse,” Judy Schuster recalls. But that didn’t deter representatives from UnitedHealthcare’s HouseCalls program from reaching out to Paul Schuster to arrange an appointment with him.


Through the HouseCalls program, a nurse practitioner visits a Medicare Advantage plan member in his or her home armed with a tablet that allows the visiting care practitioner to access the member’s clinical data and health history before performing a physical exam and identifying any potential health risks. The technology makes the program a good fit for baby boomers, who are used to the convenience of accessing services when and where they want them.

For Paul Schuster, the program was a lifesaver.

After he finally agreed to a house call in November 2014, a nurse practitioner arrived at the Schuster home in Allenton, Wisconsin. She immediately diagnosed him with extremely high blood pressure and dug in her heels until he scheduled an appointment to see a physician about the condition.

“She was very persistent, and said she wouldn’t leave until I made an appointment. In other words, I didn’t have much choice,” Paul Schuster recalls with a laugh.

That persistence paid off when a chest X-ray at the doctor’s office revealed mass on his lung, and he was diagnosed with cancer.

His reluctance to go to the doctor is far from unique. In fact, the Centers for Disease Control and Prevention reports in 2016 that less than half of Americans age 65 and older are up to date with preventive services such as immunizations and screenings for chronic conditions.

Paul Schuster underwent radiation to shrink the mass, and his cancer is now in remission. He is grateful for the HouseCalls program. “People think health care is nosy. It’s not like that at all. I think it’s a good thing.”

Personalizing the experience

For today’s baby boomers, managing their personal health care is more accessible than ever — from scheduling home visits with health providers to receiving personal health care reminders via text, phone or email, to using telemedicine, which some health plans now offer.

According to the Social Security Administration in 2015, 10,000 baby boomers turn 65 each day.

“It’s all based on preferences. It’s very different from not feeling well and going to the doctor or going to urgent care,” says Steve Nelson, chief executive officer of UnitedHealthcare’s Medicare and retirement business. “They’re looking for more information. They’re looking to have a little more control of their health care destiny.”

Dr. Efrem Castillo, UnitedHealthcare’s chief medical officer, says having engaged, interested patients also makes the job easier for their physicians.

“Baby boomers are much more involved in their care. They have expectations of value, outcomes and improvements in the patient experience. They’re informed consumers — much more than in previous generations,” Castillo says.

For a physician, “you only achieve good outcomes if you have an activated, engaged patient,” he says.

This fits with findings of a survey 2015 from the consultancy Deloitte, which found about one-third of respondents believed doctors should encourage patients to do research and ask questions about their planned treatment. More than half of respondents also want to do their own online searches for health care-related information, and more than a quarter use technology to keep track of health and fitness goals.

Staying informed

Today’s new Medicare Advantage population is particularly tech- and social media-savvy, comfortably using email, text messages and the internet to help make more informed health care decisions.

It’s now possible to use extensive data about health plan enrollees to aid them with scheduling medical appointments or referring them to programs to help them manage their chronic conditions. “There’s an incredible convergence with this new appetite for information in the senior population and the availability of this data coming together to allow this to happen,” Nelson says.

Access to data and information may too have been a lifesaver for Miriam Wilks of the Denver, Colorado area, who received a reminder call from UnitedHealthcare in spring 2015 that she was overdue for her mammogram. “As we get older, time flies and we don’t think about it,” she says.

The representative offered to make an appointment for her, and the mammogram revealed Wilks had a cancerous tumor against her rib cage. She underwent a double mastectomy, and because the cancer was caught early, she didn’t need to undergo radiation or chemotherapy.

Wilks credits her good outcome “to my UnitedHealthcare Medicare Advantage plan calling and making an appointment for me.”

UnitedHealthcare prides itself in “meeting people pretty much any way they want,” Nelson says, whether it be through proactive phone calls to offer a reminder, email, or fielding a member’s call.

Finding the right fit

In 2016, some 18 million Americans, or nearly one-third of the Medicare population, had signed up for a Medicare Advantage plan, according to the Centers for Medicare & Medicaid Services. That’s up nearly 50 percent from 2011. UnitedHealthcare accounts for approximately 20 percent of the Medicare Advantage market.

The company aims to empower seniors and other Medicare beneficiaries in their search for quality health care. UnitedHealthcare’s Medicare Advantage members can use a digital health platform provided by Rally Health, a digital hub that helps users manage their health and find providers that meet their unique needs, based on factors that matter most to them — such as location, gender, languages spoken, and ratings from fellow consumers. Starting next year, they also will be to shop based on price.

“People on Medicare Advantage are often living on fixed incomes, so managing their health care costs is important to them,” says Grant Verstandig, founder and CEO of Rally Health. “At the same time, the specialized search tools “encourage visits to higher-quality physicians.”

“If you feel like you have control and are empowered, it will help you feel a little more secure and at peace with navigating the health care system,” Nelson says.


On the web: UHCMedicarePlans.comOpens a new window

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