Accessing the [Medicare] Advantage
Broach the topic of healthcare in America, and the ensuing discussion is likely to take place at top volume. Everybody, it seems, has an opinion about spiraling costs and lack of access to care. One approach to streamlining expenses while retaining high-quality care is Medicare Advantage, a plan that is growing in popularity and is increasingly providing coverage to more and more seniors at the Jewish Home.
Medicare, notes Stephen Martinez, Ph.D.,
Executive Director of Los Angeles Jewish Home IPA and the Levy-Kime Geriatric
Community Clinic, located on the Jewish Home's Eisenberg Village campus, is a
straight fee-for-service arrangement. When Medicare Advantage was introduced in
the late 1990's (initially under the name Medicare+Choice), that calculus
changed. An HMO-type plan sponsored by the U.S. government, Medicare Advantage
offers enrollees additional benefits not covered under traditional Medicare,
usually at no extra cost.
"The cost of Medicare is actually quite high, so Medicare Advantage is often a good deal for seniors because they pay a fixed premium amount," Martinez says. "Here at the Home, we currently offer two Medicare Advantage plans to residents, but we will undoubtedly be expanding that. Within the next two or three years, we anticipate a majority of our residents will have opted for Medicare Advantage."
The plans provide a broad range of coverage, from dental care to eyeglasses and prescription drugs. But, Martinez says, there are other perks as well. "Medicare Advantage helps to promote wellness, so it can cover things like gym memberships and, depending on the Medicare Advantage plan, memory classes here at the Home. The focus is really on improving outcomes and maintaining health over time for our Seniors."
Residents on Medicare Advantage plans see Jewish Home staff physicians as their primary care doctors. For specialist visits, they have access to a network of highly skilled clinicians selected by the Home. "Once a specialist builds a relationship with us, they tend to stay in our orbit," Martinez says. "Right now, we're above 90 percent retainment. It's important for our residents to have consistency in care, and Medicare Advantage tends to provide that, which is one reason why our residents are really happy with the plans."
This June, the Home hosted a Medicare Advantage Q&A with one of the brokers it uses to facilitate program enrollment. The goal of the session was to educate residents, giving them an opportunity to explore whether Medicare Advantage might be a good fit. As a special thank you to the residents for their attendance, immediately following the presentation the broker sponsored a Casino Night, bringing in a professional company to convert the Levy-Kime Clinic (temporarily) into a Las Vegas-style gaming parlor.
"The whole event was a success because it simultaneously enabled residents to learn about Medicare Advantage and to have a great time," Martinez enthuses. "We had about 50 people attend, and one resident told me it was the most fun she'd had in years!"