The availability and accessibility of quality healthcare are directly correlated with health outcomes: higher quality care results in more positive health outcomes, while poor quality care results in more negative health outcomes. The World Health Organization (WHO) has estimated that, globally, high quality care could prevent 2.5 million deaths from cardiovascular disease alone. In the United States the problem is exacerbated for those aged 65 and older, who require specialized care for issues commonly associated with aging— high blood pressure, fall injuries, hearing loss, incontinence, osteoarthritis, and dementia— but may not be receiving the care required to age well.
While an ounce of prevention is certainly worth a pound of cure, the U.S. health system isn’t currently streamlined to handle the preventative care needs of an aging population. For example, according to the CDC, More than 34 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. Diabetes affects many areas of the human body including the digestive system, feet, heart, and eyes, to name a few. Furthermore, the social determinants of health like activity levels, social support networks, and eating habits, are all also part of the cycle of health for a person with diabetes. Treating a patient comprehensively, requires seamless communication and coordination between specialists of each affected body part. This is where coordinated interdisciplinary care comes in and can truly make a difference.
What is Coordinated Interdisciplinary Care?
By its very nature, healthcare is complex. The trail of paperwork sometimes seems miles long and is wrapped up in security and privacy, warped by words and phrases that can feel like another language. There are specialists in general medicine, men’s health, women’s health, geriatric medicine, chiropractic, dentistry, and mental health, just to name a few. As we grow older, our need grows across the full spectrum of health, and with it the number of people participating in managing our general wellness. But while medical specialists are traditionally organized around parts of the body, disease self-organizes around the entire body. This makes the proper coordination of care between primary care physicians and specialists, particularly for older Americans, a deciding factor in health outcomes. That’s because 85 percent of older Americans have a chronic condition, while roughly 60 percent have two or more chronic conditions. Coordination of care across multiple disciplines increases positive health outcomes by removing gaps in healthcare. This, in turn, builds a strong foundation for a healthcare support network, better tracking of comorbidities and health symptoms, and monitoring both medication adherence and interactions.
Importantly, coordination of the clinical component is critical to creating positive health outcomes, but it isn’t the only necessary added value for better managed and better prepared healthcare.
Better Healthcare Requires an Expanded View of Interdisciplinary Care
True interdisciplinary care means more than a visit to the doctor, particularly for the elderly who are among society’s most medically and socially vulnerable. Successful care is a combination of science, economics, and emotions. Our emotions and beliefs, in particular, significantly impact the decisions we make. The doctor can prescribe or recommend medication, a healthy diet, physical therapy, more rest or physical activity, and less stress. But if the social determinants of health— income, housing, education, literacy, social support networks, mental state, etc.— negate these recommendations, then they are made in vain. Further still, basic trust plays a critical role in health outcomes; if patients don’t trust their doctors, and don’t believe their recommendations are worth the effort, they will not realize the potential benefits of care. To be broadly successful, coordinated interdisciplinary care has to reach outside of the doctor’s office to where 80 percent of health happens: in patients’ daily lives. And while we have to consider the balance of resources— what level of care is a basic human right— expanded interdisciplinary care must, and does, consider resources and tools such as a food card, transportation, socialization, exercise, and rent assistance. With more than 17 percent of Americans skipping food, and 9 percent skipping rent, to pay for healthcare, it’s common sense (supported by statistics) that people who don’t have to choose between rent, food, and healthcare are likely to make healthier choices.
Medicare Advantage is Leveling the Playing Field in Healthcare
In healthcare, we’re always looking for ways to create pathways to wellness for as many people as possible. For older and aging Americans, Medicare Advantage offers the ability to access Medicare benefits through private health coverage plans, which in many cases have added coverage available. What’s more, Medicare Advantage is forever shaping and changing with the needs of communities and individuals.
Recently, laws surrounding Medicare changed, allowing health coverage providers to put excess revenue back into their Medicare Advantage plans. But it’s what that does for Medicare recipients that matters. The revenue that is being rolled back into plans is being used to expand interdisciplinary care to include patients’ lives and everyday needs, with access to the gym, help with groceries, and even transportation assistance for doctor’s appointments at no additional charge. These new benefits have been questioned, but fundamentally it makes perfect sense. Increased activity, healthful foods, and help getting to the doctor all help people become and stay well. This, in turn, reduces chronic illness, which reduces the strain on the health system, and allows for proper allocation of resources so that everyone who needs healthcare can access it in a timely manner. In a way, Medicare Advantage has become the not-so-secret, though still overlooked, ingredient in creating sustainably expanded interdisciplinary care.
What’s more is that it doesn’t have to remain overlooked. Licensed local agents, like those who work for my company, Advocate Health Advisors, seek out the most vulnerable in their local communities, those who don’t have the resources to find or understand healthcare resources. They help older Americans not only understand Medicare benefits, but also how to access all of the ones for which they are eligible. In this way, they too are invaluable participants in patient care, and conductors of coordinated interdisciplinary healthcare for older adults living right in their own communities.
American healthcare is at a crossroads. As we re-envision coordinated interdisciplinary care, and what it means and will continue to mean for our aging population, we must leave no program unturned. As healthcare professionals— both inside and outside of the doctor’s office— we must all be more thoughtful in our interactions with patients and in our approach to healthcare. More importantly, we must use all available resources— from doctors to nurses to health coverage companies to licensed local agents— to facilitate interdisciplinary care systems that not only create whole healthcare but whole people.
Dr. Hale is the CEO of Advocate Health Advisors, a company he founded to help people make the best decisions about their healthcare. A decorated officer, Dr. Hale served thirty years in the military, ranging from peacekeeping operations to combat with US Special Operations Command in support of the Global War on Terror. Concurrently, in the world of business, he worked with some of the top companies in the fields of healthcare services, information technologies, telecommunications, and personnel management.
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Dr. Darwin Hale
Dr. Darwin Hale is Founder CEO of Advocate Health Advisors.
