SCAN Group announced on tuesday it is launching a new medical group dedicated to virtual and in-home primary care for Medicare Advantage members, many of which will be covered by its own subsidiary health plan.
Long Beach, California-based SCAN, whose assets include SCAN Health Plan’s Medicare Advantage, announced that the new company will be called Welcome Health. The SCAN Group, which will become the primary owner of Welcome, said the non-profit provider will offer affordable services to members of SCAN Health Plan and other Medicare Advantage plans.
Dr. Scott Weingarten, who recently joined SCAN Health Plan after decades at Cedars-Sinai, will become CEO of the new provider. He said SCAN has recognized that through member focus groups and market research, there is a need for an older-oriented provider that specializes in home and virtual visits.
“We find that there is a significant percentage of older people who do not seek help because of problems that make it difficult for them to get to their doctor’s offices,” Weingarten said.
Download the Modern Healthcare app to stay on top of industry news.
These problems include transportation, reluctance to seek help from adult children, and problems with mobility or urinary incontinence, he said.
Weingarten’s own mother refused to go to the clinic during the COVID-19 pandemic for fear of contracting the coronavirus.
“I was unable to find a doctor who would see her at home,” he said.
Welcome clinicians will be experienced in helping older adults, including with regard to common features of elderly care such as dementia, falls, weakness, polypharmacy, and loneliness.
The practice has hired three full-time doctors – two geriatricians and a therapist – and will also have nurses, nurse practitioners, social workers, pharmacists and community health workers. Dr. Deena Goldwater will be Welcome’s VP of Medical Assistance and Chief Scientist. Goldwater joins Welcome from the Greater Los Angeles VA and David Geffen School of Medicine at the University of California Los Angeles, where Goldwater was Associate Clinical Professor of Cardiovascular and Geriatric Medicine.
Welcome will begin accepting patients in March 2022. In addition to home and virtual care, it will initially have one physical clinic, which will expand from there, as focus groups have shown, some older people still prefer personal care.
Welcome joins a rapidly growing list of providers targeting the Medicare Advantage marketplace. The number of health clinics targeting the chronically ill elderly has grown rapidly in recent years, including through operators such as ChenMed, Oak Street Health and Partners in Primary Care.
These arrangements usually assume that health care providers take full financial risk of the care of Medicare Advantage members in exchange for flat monthly payments based on the health status of the patients.
Privatized Medicare is more expensive to the government than traditional Pay-for-Service Medicare, and a recent Commonwealth Foundation study found Medicare Advantage does not reduce hospital and emergency room visits compared to traditional Medicare enrollment. The researchers also noted that people in both programs had comparable rates of chronic disease.
Weingarten declined to say how many patients expected to see Welcome, but said the company made a five-year projection based on comparable Medicare Advantage providers such as Oak Street Health, Iora Health and CareMax.
With the launch of Welcome, the SCAN Group will be more like Alignment Healthcare and Bright Health, Medicare Advantage, which also have providers. SCAN Health Plan is a 220,000-member Medicare Advantage Plan in California, Arizona, and Nevada. The plan will serve as Welcome’s anchor client, but plan members will still be able to choose where they can get help, Weingarten said.
“If Welcome Health delivers better service at an affordable price and more experience, some SCAN members will choose Welcome Health,” he said. “If we don’t, SCAN members will be selected from a list of many other medical groups and (independent practice associations) in the communities we serve.”