Longer, frequent appointments with doctors and care team members. Appointments average around 40 minutes, as opposed to the standard 15- to 20-minute primary care appointments.
Use of interdisciplinary teams to coordinate care, educate patients, and proactively manage disease. Patients have more convenient, individualized access to physicians, nurses, social workers, pharmacists, and behavioral health therapists. The care team also may include community health workers or health coaches who can help extend care delivery to patients’ homes.
Delivery of care under a risk-based model as opposed to fee-for-service (FFS). Although there are some senior-focused primary care clinics that operate under FFS, the frequency of appointments and higher up-front costs lends itself better to value-based payment models. Some senior-focused primary care programs will serve only Medicare Advantage patients.
Use of data for better care delivery. Many senior-focused primary care programs will build their own tools, platforms, libraries, or frameworks to track and engage patients and identify those most in need of attention.
There are many senior-focused primary care models currently in the market. Generally, ownership of these models falls into the following categories:
- Provider-owned: Northwell HouseCalls, Geisinger Forward 65, etc.
- Payer-owned: CenterWell, CareMore, etc.
- Private disruptor/startup: Oak Street Health, Iora/One Medical, etc.
Despite the different types of ownership, senior-focused primary care programs largely operate their care models in similar ways. There are minor differences in how defined their target market is, whether they are predominately home-based or facility-based, and what kind of payment models they participate in (i.e., how much risk they take on).
Typical target market
While any adult over 65 could benefit from senior-focused primary care services, the higher cost of treating these patients means that most organizations focus on certain segments of the population. Individuals are often one or more of the following:
- Medicare Advantage beneficiaries
- Polychronic individuals
- Low-income, underserved populations (includes high-risk Medicare/MA/dual eligible patients
The average age for seniors enrolling in senior-focused primary care programs is 70 years old. Most of these programs are in suburban and urban areas, given the concentration of patients in those locations. Although many models are facility-based, some will target home-bound seniors.