Health Care

SCAN Group launching in-home, virtual Medicare Advantage provider

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SCAN Group announced Tuesday it’s launching a new medical group specializing in virtual and in-home primary care for Medicare Advantage members, many of whom will be covered under its own health plan subsidiary.

Long Beach, California-based SCAN, whose holdings include the Medicare Advantage plan SCAN Health Plan, said the new company will be called Welcome Health. SCAN Group, which will be Welcome’s majority owner, said the for-profit provider will offer affordable care 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 be CEO of the new provider. He said SCAN realized through focus groups with members and market research there was a demand for a senior-focused provider that specialized in in-home and virtual visits.

“We’re finding there’s a sizable percentage of seniors who are not seeking care because of the challenges for them to make it into their physician’s offices,” Weingarten said.

Those challenges include transportation, not wanting to ask adult children for help and mobility or incontinence issues, he said.

Weingarten’s own mother refused to go into a clinic during the COVID-19 pandemic out of fear of contracting the coronavirus.

“I was unsuccessful in finding a physician who would see her in her home,” he said.

Welcome’s clinicians will have experience providing care to older adults, including addressing common features of senior care like dementia, falls, frailty, polypharmacy and loneliness.

The practice has hired three full-time physicians—two geriatricians and an internist—and will also have nurses, nurse practitioners, social workers, pharmacists and community health workers. Dr. Deena Goldwater will serve as Welcome’s vice president of care delivery and chief science officer. Goldwater joins Welcome from the VA of Greater Los Angeles and the David Geffen School of Medicine at UCLA, where Goldwater was an assistant clinical professor of cardiovascular and geriatric medicine.

Welcome will start seeing patients in March 2022. In addition to in-home and virtual care, it will have one physical clinic initially and expand from there, as focus groups showed some seniors still prefer in-person care.

Welcome joins a rapidly growing list of providers focused on the Medicare Advantage market. The number of medical clinics targeting chronically ill seniors has grown rapidly in recent years, including by operators like ChenMed, Oak Street Health and Partners in Primary Care.

Such arrangements typically involve the providers taking full financial risk for Medicare Advantage members’ care in return for fixed monthly payments based on the patients’ health status.

The privatized form of Medicare costs the government more than traditional, fee-for-service Medicare, and a recent Commonwealth Fund study found Medicare Advantage doesn’t reduce the frequency of hospital and emergency department visits compared with traditional Medicare enrollment. Researchers also noted that people enrolled in both programs had comparable rates of chronic conditions.

Weingarten declined to say how many patients it expects Welcome to see, but he said the company created five-year projections based on comparable Medicare Advantage-focused providers like Oak Street Health, Iora Health and CareMax.

Welcome will be more like Alignment Healthcare and Bright Health, Medicare Advantage plans that also employ providers. SCAN Health Plan is a Medicare Advantage plan with 220,000 members 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 get care, Weingarten said.

“If Welcome Health delivers better quality care at an affordable cost and a better experience, some SCAN members will choose Welcome Health,” he said. “If we don’t, then SCAN members will choose from a list of many other medical groups and (independent practice associations) in the communities that we serve.”

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