Opinion: Addressing the Mental Health Needs of the Medicare Population

For the 63 million Americans who receive Medicare benefits, the challenges that significantly affect their mental well-being continue to grow. Projections show that the number of Medicare beneficiaries will grow by 1.5 million per year by 2029, with the majority of eligible participants consisting of people aged 65 and over, making the urgent need to ensure that this population has access to solutions that meet their unique and evolving needs.

As people age, we may face a variety of health challenges that can negatively impact mental health. Physical decline can reduce self-sufficiency, while increasing physical and mental health problems can add stress and anxiety. Estimates show that nearly 20% of adults over 65 will experience some form of mental health challenge, and nearly 5% will have a severe mental illness. In addition, there are societal challenges that have a negative impact on mental health, significantly highlighted by the COVID-19 pandemic, which has increased the risk of loneliness and social isolation already prevalent among this population. Research shows that almost 25% of those aged 65 and over are socially isolated, with contributing factors being medical conditions and life changes such as losing loved ones or living alone. Loneliness and social isolation are associated with an increased risk of mortality, higher rates of depression, and lower success in the treatment of physical and mental illness.

Although challenges in accessing mental health services can occur at any time in life, there are nuances in older populations that we need to recognize and address. From functional limitations that may affect their ability to attend in-person care, to the stigma of seeking mental health therapy, to their discomfort with technology, payers must adjust care efforts to ensure that an aging population can more easily overcome obstacles. One way is to provide care integration efforts that help payers reduce health care costs and improve health outcomes. Payers can also play a role in enabling integrated care through initiatives with providers. Incorporating behavioral health screenings as a component of chronic disease management allows for early identification of mental health problems, timely intervention, and removes barriers to care. Although all individuals benefit from a holistic health approach, integration is essential as they age, as they are more likely to experience multiple co-morbidities.

Primary care physicians are at the forefront of health care for many aging communities. Often, mental health conditions can manifest as physical illnesses. Depression and anxiety are common among those 65 and older, but these individuals are more likely to initially report physical symptoms. The generational stigma associated with behavioral health can discourage them from seeking help, making it vital that primary care providers feel informed and have the tools necessary to identify and refer members for care if a problem with mental health. By prioritizing provider education, payers can provide targeted information and assistance needed to assist providers in addressing their patients’ mental health.

There is also a need for innovative applications of technology and partnerships between health plans, providers, and community organizations to address issues that impact the mental and physical well-being of older adults and their caregivers. In one innovative use, Centene recently launched a pilot program that proactively engages members based on data analysis and recommendations. Through the use of evidence-based telephone care and virtual care appointment training, the program fosters collaboration between health plans and providers to coordinate member treatment goals, processes and interventions to reduce gaps in care. By fostering these relationships, payers can support health care teams as they more diligently navigate the current and emerging challenges that arise among Medicare patient communities by focusing on local social determinants of health and isolation using whole health approaches. that meet the needs of different communities.

As the number of Medicare recipients continues to grow, it is essential that we develop generationally appropriate solutions to meet their unique mental health needs. Innovative solutions and policy advances that focus on providing improved access to high-quality, integrated care can help our nation’s aging population achieve the best health outcomes and live life to the fullest.

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