Optums Geriatric Services Support Case Management

Initiatives Strive to Help Older People Stay Healthy

Growing older often brings increased health burdens, thereby adding to the stresses older people already face. For older patients, one of the biggest challenges is coordination of the many things they need to do in order to stay healthy. Older people face issues ranging from medical problems to financial challenges, depression, isolation, emotional strain, cognitive difficulties, and environmental issues, such as the risk of falling. 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 effectively as possible.

3 out of 4
Number of Americans over 65 years of age with multiple chronic conditions
Chronic Conditions among Medicare Beneficiaries, CMS

Optum is helping UnitedHealth Group, working in collaboration with AARP, to develop a series of pilot Case Management programs in an effort to better understand the characteristics, needs, and general health of older adults. The goals of those initiatives are to improve care coordination and delivery of services, to better control costs, and to promote high quality of care for their members. Optum provides the clinical services to support those initiatives by offering a series of integrated capabilities, including behavioral solutions, clinical solutions, and face-to-face visits.
The aging of the population, the prevalence of chronic disease, and the rapidly rising cost of health care in the U.S. provide a sense of urgency and immediacy for finding innovative solutions that improve the health and well-being of seniors and prevent or delay debilitating and costly disease onset. CMS

78.4%

Percentage of men over the age of 60 who are overweight or obese, with 68.6% as the percentage of women
Centers for Disease Control and Prevention

Case Management
In response to the fact that a very large percentage of elderly Americans suffer from multiple chronic conditions, Optum is leading research and evaluation efforts to determine how best to manage the care of older adults with various chronic conditions. The pilot Case Management programs targets those with chronic illnesses in high disease prevalence areas living in five states: New York, North Carolina, Ohio, Florida
Continued

6%
Percentage of Medicare beneficiaries who were older than 65 and diagnosed with depression in 1998
J Am Geriatric Soc paper, Crystal et al., 2003

and California. The pilot Case Management programs strive to keep patients healthy, stable, and out of the hospital. The program seeks to meet the clinical, social, and emotional needs of patients via face-to-face visits, telephone care managers, social workers, and depression advocates. In its second year, the program demonstrated increased quality of care. The program tracks evidence-based medicine (EBM) metrics to evaluate the effectiveness of the programs, which indicate that engaged participants on certain medications are more likely to maintain or increase levels of compliance with those medicines and that engaged participants with diabetes are significantly more likely to have an annual office visit.

Quality of Life
Even though chronic conditions such as diabetes and hypertension can severely impact the lives of older adults, less common health concerns such as the risk of falling, hearing loss, and incontinence often go overlooked, yet can have the most-detrimental effectsboth physically and emotionallyon those patients lives. According to data from the Centers for Disease Control and Prevention, more than one-third of those over the age of 65 experience falls each year. In 2010, the pilot Case Management program screened 1,645 actively engaged AARP members for risk of falls. Through a face-toface engagement, the program resulted in 75% of those members having no further falls that year by reducing environmental risks, obtaining doctors orders for equipment, reviewing medications, and addressing footwear and vision needs.

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