Opinion Extra

There’s still work to be done to improve SC seniors’ well-being

Approximately 10,000 baby boomers turn 65 each day.
Approximately 10,000 baby boomers turn 65 each day. The State file photo

South Carolina received some good news lately. Children’s health is improving, and our state has yet again moved up in a national ranking of childhood well-being – hitting a new high.

The 2018 KIDS COUNT Data Book ranked South Carolina 38th for overall children’s well- being — the fifth consecutive year of forward progress.

As chief medical officer for WellCare Health Plans of South Carolina, a health plan that helps manage the care of children on Medicaid, I am proud of the work we’re doing and the progress we’re seeing around children’s health.

More than half of S.C. children qualify and are enrolled in the Medicaid program. In fact, WellCare ranks in the 90th percentile for helping pregnant mothers access timely prenatal visits. As a physician trained in obstetrics, I can assure you that having a healthy pregnancy is one of the best ways to promote a healthy birth and, in turn, a healthy childhood.

While this is great progress, there’s more to any story than just the beginning. Our state now has an opportunity to improve the health narrative of our most vulnerable adults and seniors to help improve care later in life.

Approximately 10,000 baby boomers turn 65 each day, and, on average, more than half (52 percent) will develop a severe disability that will require long-term services and supports. In fact, South Carolina spends more than $1.5 billion each year on seniors and those with long-term disabilities – a population whose individual healthcare costs are more than five times the cost of children.

As states across the country look for innovative solutions to help improve quality and lower costs, Medicaid managed care programs can provide improved care coordination and cost savings by helping seniors age in place as opposed to more costly institutional-based settings such as hospitals and nursing facilities. After all, in 2015, the median annual cost for nursing facility care was $91,250 compared with $45,800 for one year of home health aide services.

At WellCare, we take a member-centric approach, letting our members and their families drive the care plan, which includes a focus on aging in place, offering a network of quality providers and integrating necessary social service supports such as food, housing and transportation.

And we’re seeing first-hand how successful these programs can be. In Hawaii, we’ve seen an 18 percent reduction in nursing facility placements since 2009, and in New Jersey, of the approximately 8,000 beneficiaries receiving long-term services and supports, 6,000 are receiving that care in their homes or in their communities. After all, we all hope to stay in our homes as long as possible.

Estimates show that applying the outcomes WellCare has delivered in other states could save South Carolina more than $270 million in state funds over four years.

S.C. Medicaid managed care has proven results for our children. Let’s bring this same expertise to our seniors and those living with disabilities.

Contact Dr. London at Robert.London@wellcare.com.