How Concierge Care for Low-Income Seniors Can Improve Outcomes and Reduce Costs

Christopher Chen, MD, is the CEO of ChenMed, a physician practice that aims to bring concierge-style medicine and better health outcomes to the neediest populations—low-income seniors managing multiple complex chronic conditions. Under his leadership, ChenMed has grown from 4 senior medical centers in Florida in 2010 to the more than 40 locations in 9 US markets today. Raised in South Florida, Chen graduated from the University of Miami’s Honors Program in medicine, and completed his medical training at Beth Israel Deaconess. He also held a specialty position studying cardiology at Cornell University Medical College.
While little seems certain about the current healthcare reform debate in Congress, the transition to value-based care is well underway. We are beginning to see that when providers are paid to deliver better care at lower costs, they can have a real impact on both.
While little seems certain about the current healthcare reform debate in Congress, the transition to value-based care is well underway. We are beginning to see that when providers are paid to deliver better care at lower costs, they can have a real impact on both.
 
The question now is, what about the population that is responsible for the most healthcare costs—low-income seniors managing multiple chronic conditions? Medicare has seen some promise with accountable care organizations, which generated more than $466 million in total program savings in 2015. However, a recent study receiving some attention suggested that physicians treating high-cost, high-need patients struggle under value-based care models.  
 
We were surprised by that recent study because our experience has been the opposite. We have found that by providing intensive, “concierge-style” care to this population, we can have meaningful impact on their health outcomes and costs.
 
When it comes to delivering value-based care to seniors, Medicare Advantage (MA) is playing an increasing role. Today, more than one-third of Medicare beneficiaries are enrolled in a MA plan—that’s a 71% increase in the last 7 years. My company, ChenMed, has been a full-risk MA provider for years. In this arrangement, MA plans provide a set amount per patient for overall healthcare costs.
 
Since we were founded, MA growth has surged, but policy makers, payers, providers, and patients may still have questions about whether MA can meet the healthcare needs of millions more US seniors and address the challenges we face to bring down costs while improving care outcomes.
 
At ChenMed, we have identified some compelling results that suggest MA remains worthy of even greater attention—particularly if the value-based care model and physician culture of service are aligned. Our model and strategic association with MA means we’re rewarded when we keep patients as healthy as possible to avoid costly emergency room (ER) visits, hospital admissions, and complications in their chronic conditions. Recent analysis of our claims data and data collected by our electronic health record show impressive results that, when measured against comparative CMS data, suggest MA can ultimately lead to lower costs and deliver better health outcomes nationwide.
 


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