SCOs – “The best kept secret in health care in Massachusetts”

Today’s MetroWest Daily News includes an op-ed arguing for paying more attention to SCOs – the Senior Care Options programs that provide integrated, patient-centered care to seniors who are covered by both Medicare and Medicaid. The op-ed, by two SCO leaders, John Baackes, CEO of Senior Whole Health and Robert Master, CEO of Commonwealth Care Alliance, rightly calls SCOs “the best kept secret in health care in Massachusetts.”

SCOs are singularly dedicated to serving the most vulnerable seniors in the commonwealth. They coordinate comprehensive health care and community-based services, such as personal care, daily living assistance and transportation services, that make it possible for seniors to live at home as long as possible.

Part of what makes caring for duals so expensive is that Medicare and Medicaid have different ways of paying for services that often conflict, leading to fragmented care.

The toll of this fragmented and inadequate care for seniors results in the deterioration both of the health status and outcomes of these patients as well as an increase in the cost of their care. Treatable conditions quickly spiral out of control, requiring more frequent and longer hospital stays and, unnecessary admissions to nursing homes for long-term care. Not only is this inefficient, it’s unnecessary and ultimately not what seniors want.

The four SCO plans in Masssachusetts – Commonwealth Care Alliance, Evercare, NaviCare (Fallon Community Health Plan) and Senior Whole Health – have the ability to coordinate Medicare and Medicaid funds to provide a full range of services not otherwise available to seniors. SCOs, for example, offer a full range of dental services not available to those who have Medicare or Medicaid.

And it works. JEN Associates found that the program reduces hospital use by 25 percent and keeps seniors out of nursing homes longer. By integrating comprehensive health care and community-based services, such as personal care, daily living assistance and transportation, SCOs create the support system for seniors to live confidently in their community.

All care should be delivered this way.

SCOs are a great example of why we have confidence that, done right, medical homes and ACOs can lead to real improvements in care, at a lower cost.

The article points out that only only 14 percent of eligible seniors are currently enrolled in SCO plans. We support the goal increasing awareness of SCOs, and using their experience to inform our payment reform push.
-Brian Rosman

About HCFA

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This entry was posted in Healthcare Cost Control, MassHealth/Medicaid. Bookmark the permalink.

One Response to SCOs – “The best kept secret in health care in Massachusetts”

  1. Senior Care Options is a partnership between MassHealth and Medicare that provides a complete package of health care and social services for low-income seniors. No one is required to join Senior Care Options where enrollment is voluntary.

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