Poll Finds Major Care Coordination Gaps Among Seniors

Just over one-third of seniors rely on a family member to coordinate their medical care, and roughly another one-third say no one manages their care among multiple providers—pointing to huge gaps in care coordination when this task is a growing priority.

A Harris Poll of 1000 seniors conducted for CareMore, a physician-founded care delivery system that operates in 7 states, found that 85% of seniors have been diagnosed with at least 1 serious health condition and 64% have seen 3 or more healthcare providers in the past year, showing the need for care coordination.

But 34% of these seniors reported that a family member coordinates their care, and 35% said no one does. This raises the question: are seniors getting the right care at the right time?

The poll found that most seniors (61%) are asked if they understand their treatment plans, but less than half (43%) are asked specifically about treatments and medications prescribed by other doctors. After hospitalization, 63% of seniors say that no one helped coordinate their care—even though Medicare increasingly penalizes hospitals when patients return to the hospital within 30 days of discharge.

In recent years, CMS has tried to promote new payment models to promote better coordination of care. A $41 per patient per month charge is available to practices to care for seniors with multiple chronic conditions; starting in 2017, primary care practices will be able to bill for collaborative care, a model that promotes putting the behavioral health practitioner under the same roof.

However, there are few reports of how well these payment models work in practice, because a requirement for the care coordination fee is that the senior designate the primary care practice to receive the payment. Some questioned whether seniors would understand the need for doctors to collect a fee for an activity that many think their doctor should do anyway.

“Navigating the healthcare system is inherently challenging and is even more perplexing for seniors, as many suffer from chronic diseases like heart disease, hypertension, and diabetes, and are at high risk for complications,” Sachin H. Jain, MD, MBA, FACP, president of CareMore, said in a statement.

Among other survey findings:

• Nearly all seniors (95%) are happy with the quality of care from their provider.
• Most seniors (56%) would welcome programs from their provider to help them manage their health. Those in fair or poor health are more likely to want this assistance than those in good health (71% vs 47%).
• A slim majority (51%) say it is at least somewhat important to get regular calls from their doctor’s office to follow-up on their healthcare plan.

The survey also sought information on broader quality-of-life issues. A little more than one-third (36%) said they would welcome more chances to interact with their communities, and more than a quarter (27%) said they would like their provider to connect them with other people or activities that would keep them healthy. A sizable share (38%) said they would welcome advice on diet and nutrition, and this number rose among those in poorer health.

More than 1 in 10 (11%) of seniors lack reliable transportation for medical appointments, and less than 1 in 3 (32%) said offering transportation was just as important was taking their blood pressure.