Originally published in The Tennessean, October 2019
I’m fortunate to hear many success stories from BlueCross members, but a recent one particularly stuck out. A member who was due for a colonoscopy needed help scheduling it. We helped him make the appointment and arranged transportation. The screening results showed he had an early stage of colon cancer that was then able to be treated.
After his recovery, he wrote us a letter. “Had you not explained to me the importance of getting the screening, I probably wouldn’t have gotten it,” he said. “Most likely, this cancer would have consumed me.”
While I was pleased to hear his treatment was successful, his use of “consumed” stuck with me. It gets to the heart of why BlueCross began offering Medicare plans to Tennesseans. As we get older, we face more complex health challenges. When people become eligible for Medicare, choosing a plan should not be an additional burden.
We listened to our members and recognized that the Medicare benefit structure needed to be more tailored to an individual’s health care needs and provide services that improve our members’ ability to lead active, healthy lives.
A whole-person approach
Our Medicare Advantage (MA) plans grew out of this need for an integrated health benefit. In addition to services covered by Medicare, our MA plans offer a pharmacy benefit and access to supplemental benefits like vision, dental and hearing. These plans behave much like a health insurance plan that members were likely accustomed to during their careers, and allow for a more holistic, whole-person approach to their benefits.
The member I introduced earlier is on an MA plan and was guided by the efforts of our engaged member education and outreach team. While Medicare itself encourages seniors to undergo best-practice preventive screenings, we take an active role in arranging these screenings to help remove another barrier for our members. As in the case above, the results can be lifesaving.
Seniors tell us they appreciate the benefits that help them with situations outside of disease management. Transportation to and from medical appointments and hospitalizations is one advantage in some of our MA plans. Another is food delivery and preparation for members immediately following a hospital discharge. This lets them focus on recovery rather than where their next meal is coming from. Behavioral health services also play a role, as social isolation is a very real issue for seniors.
Evolving our plans
We’ve also heard from members that they’re pleased to see us in their communities. We prioritize outreach efforts such as our member education events, where questions can be asked one-on-one with BlueCross representatives.
The Centers for Medicare & Medicaid Services (CMS) holds Medicare Advantage plans to high levels of quality outcomes. For the last four consecutive years, our PPO plans have performed above expectations with regard to those measures.
We’re continuing to adjust our Medicare Advantage plan offerings based on what our members need. For example, we’re offering the state’s first plan specifically designed to help people living with diabetes – a condition that’s increasingly common in Tennessee. We’re piloting the program in 30 counties, with benefits that will help improve access to medication, endocrinology visits, treatment supplies and even transportation.
A growing number of seniors are choosing our Medicare Advantage products to fit their lifestyle needs, due to the high degree of service and provider access we have created to coordinate care. Of course, each individual is their own greatest advocate. When thinking about a change in coverage, talk with your provider about options to consider as your health needs change.