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Optums Geriatric Services Support Case ManagementInitiatives
Strive to Help Older People Stay Healthy
Growing older oten brings increased health burdens, thereby
adding to the stresses older people already ace. For older
patients,
one o the biggest challenges is coordination o the many
thingsthey need to do in order to stay healthy. Older people ace
issues
ranging rom medical problems to fnancial challenges,
depression,
isolation, emotional strain, cognitive difculties, and
environmental
issues, such as the risk o alling. But to maintain or improve
their
health and stay in their own homes as long as possible, they
need to
be able to manage their conditions as eectively as possible.
Optum is helping UnitedHealth Group, working in collaboration
with AARP, to
develop a series o pilot Case Management programs in an eort to
better understand
the characteristics, needs, and general health o older adults.
The goals o those
initiatives are to improve care coordination and delivery o
services, to better control
costs, and to promote high quality o care or their members.
Optum provides the
clinical services to support those initiatives by oering a
series o integrated capabilities,
including behavioral solutions, clinical solutions, and
ace-to-ace visits.
Case Management
In response to the act that a very large percentage o elderly
Americans suer rom
multiple chronic conditions, Optum is leading research and
evaluation eorts to
determine how best to manage the care o older adults with
various chronic conditions.
The pilot Case Management programs targets those with chronic
illnesses in high
disease prevalence areas living in fve states: New York, North
Carolina, Ohio, Florida
3 out o 4
Number o Americansover 65 years o agewith multiple
chronicconditions
Chronic Conditions amoMedicare Benefciaries, C
78.4%Percentage o men ovethe age o 60 who areoverweight or
obese,with 68.6% as thepercentage o women
Centers or Disease Control and Prevent
6%Percentage o Medicarebenefciaries whowere older than 65and
diagnosed withdepression in 1998
J Am Geriatric Soc paper, Crystal et al., 20
The aging o the population, the prevalence o chronic
disease,
and the rapidly rising cost o health care in the U.S. provide
a
sense o urgency and immediacy or fnding innovative solutions
that improve the health and well-being o seniors and prevent
or delay debilitating and costly disease onset.
CMS
Continued
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and Caliornia. The pilot Case Management programs strive to keep
patients healthy,
stable, and out o the hospital. The program seeks to meet the
clinical, social, and
emotional needs o patients via ace-to-ace visits, telephone care
managers, social
workers, and depression advocates. In its second year, the
program demonstratedincreased quality o care. The program tracks
evidence-based medicine (EBM) metrics
to evaluate the eectiveness o the programs, which indicate that
engaged participants
on certain medications are more likely to maintain or increase
levels o compliance with
those medicines and that engaged participants with diabetes are
signifcantly more likely
to have an annual ofce visit.
Quality o Lie
Even though chronic conditions such as diabetes and hypertension
can severely impact
the lives o older adults, less common health concerns such as
the risk o alling,
hearing loss, and incontinence oten go overlooked, yet can have
the most-detrimental
eectsboth physically and emotionallyon those patients lives.
According to data
rom the Centers or Disease Control and Prevention, more than
one-third o those over
the age o 65 experience alls each year. In 2010, the pilot Case
Management program
screened 1,645 actively engaged AARP members or risk o alls.
Through a ace-to-
ace engagement, the program resulted in 75% o those members
having no urther
alls that year by reducing environmental risks, obtaining
doctors orders or equipment,
reviewing medications, and addressing ootwear and vision
needs.
2012 Optum, Inc. All rights reserved. OA 100-8406
