Seniors Want Independence—Our Health Care System isn’t Delivering

Sponsored Content

As health care providers, we often speak about healthy aging. But what does that actually mean to the people we care for, and what do they feel is needed to age well? To understand how Americans would answer these questions, CenterWell conducted the Aging Well In America survey with Morning Consult. The findings could not be clearer and should serve as a wake-up call for our health care system: Americans place a high priority on retaining their independence as they age.

Nearly two-thirds of adults – and as many as eight in 10 seniors – desire to live as long as they can self-sufficiently rather than have a longer lifespan but be dependent on others. What is also clear is that achieving that goal remains elusive for many.

The survey reveals significant barriers that threaten independence as Americans age, including concerns around declining financial resources and worsening mental health, as well as widespread underutilization of primary care, which is foundational for both disease prevention and management.

Unfortunately, the American health system is currently constructed to treat illness, not support a more proactive approach to aging well. Given the nation’s rapidly aging population, it’s imperative that we overhaul our complicated, fragmented system and invest in approaches that enable independence, quality of life and longevity in later years. Ideally, we would create a system that supports the whole individual in attaining more years of fulfillment, eliminating the false choice between living longer and living well.

We must invest more in preventive and primary care

Chronic disease is pervasive among older adults: 93% of seniors live with one or more chronic conditions. Preventive care is the most effective tool we have to stem this tide, reducing disability and slowing functional decline. Yet, according to the latest available data, fewer than half of seniors are up to date on preventive services.

Equally concerning, our survey found that more than half of older adults do not regularly see a primary care provider. According to the National Academies of Sciences, Engineering and Medicine, “primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes.” Yet, many seniors have limited access to that care, particularly in rural and lower-income areas.

A severe shortage of geriatricians and other senior-focused providers compounds this problem. There is just one geriatrician for every 10,000 seniors, a gap projected to widen in the coming years.

Without access to high-quality primary care, manageable health problems can escalate to severe disease, resulting in frequent emergency department visits and hospital stays that are driving costs to unsustainable levels.

We must take a more holistic approach to primary care

Enabling people to age well and stay independent involves more than just addressing their medical needs; it requires addressing the full range of factors that influence health. Transportation challenges, housing and food insecurity, and mental health problems greatly impact the health of our older population.

In contrast to the traditional fee-for-service system, value-based care models, particularly those built around integrated, team-based primary care, are proving that a whole-person approach works. A recent study from Humana Health Research and Harvard University found that senior-focused, value-based primary care practices increased access, with patients having 17% more primary visits than those in traditional practices. They also reduced disparities – Black and low-income beneficiaries had 39% and 21% more visits, respectively. Most importantly, outcomes improved: patients had better preventive screening rates, greater medication adherence, lower rates of poorly controlled diabetes, and experienced 11% fewer ED visits, 6% fewer hospitalizations, and 10% fewer 30-day readmissions.

These value-based primary care approaches, along with community and government-led healthy aging initiatives, will go a long way in enabling people to age well while reducing health care spending. A recent McKinsey report found that promoting healthy aging through a more holistic approach would produce economic value for the U.S, with every $1 invested in healthy aging interventions yielding $3 in health care and economic benefits.

We need to meet seniors where they are

As part of this needed evolution, primary care must be more physically and logistically accessible to seniors. Medical offices should be easy for older patients to access and located in frequented community spaces such as downtown areas and shopping centers. Primary care practices in underserved communities are especially needed.

Equally important, care should be consolidated under one roof to decrease scheduling and travel demands on patients. Co-located services—such as primary care, pharmacy, lab testing, and behavioral health—reduce the burdens that often lead to poor compliance.

While medical offices are one way to provide primary care, we must also make our services available to people in their homes when mobility challenges, transportation gaps or financial constraints make office visits unfeasible. Those constraints should not be barriers to receiving care.

We’ve heard the message; it’s time to deliver

Older Americans want independence, and our system must evolve to deliver it. That means doing a much better job of helping people stay healthy as they age by investing in preventive and primary care, expanding the pipeline of senior-focused providers, embracing value-based models, and tackling the social factors that shape health.

The message from seniors is clear. Now, it is up to all of us – providers, payers, policymakers, and health system leaders – to transform our health care system into one that supports Americans’ ability to age well.

Sanjay Shetty, MD, is the President of CenterWell, where he leads strategy, growth and operations across its health care services — including Senior-Focused Primary Care, Pharmacy and Home Health.