Since 1977, SCAN Health Plan has been a trusted provider of health coverage for California seniors. As mental health challenges among adults 65 and older have become more prevalent, SCAN has placed increased emphasis on delivering whole-person care for seniors—addressing not just physical health but also behavioral health needs to help members live healthier, more independent lives.
Eve Gelb, SCAN’s senior vice president of member and community health, explains the philosophy behind this approach: “A human being is not divided by who covers their various health services. They are a human being, and we need to support that human being to live a healthy and independent life, regardless of whether it’s medical services or social support.” This view drives SCAN’s commitment to whole-person care for seniors, ensuring members receive coordinated support for their medical, mental, and social needs.
Using Health Risk Assessments to Tailor Whole-Person Care for Seniors
As one of the largest not-for-profit Medicare Advantage plans, SCAN serves roughly 270,000 members in California, Nevada, and Arizona. The plan uses Health Risk Assessments (HRAs), mandated by the Centers for Medicare and Medicaid Services (CMS), to identify the diverse needs of members. These assessments often reveal behavioral health concerns, allowing SCAN to develop customized care plans focused on whole-person care for seniors.
To foster open dialogue, SCAN carefully frames behavioral health questions in terms of “emotional well-being” rather than directly naming conditions like depression or anxiety. This approach encourages members to share their experiences, opening doors for conversations about mental health and access to resources that support whole-person care for seniors.
Member2Member Peer Support: Building Connections to Combat Isolation
A cornerstone of SCAN’s behavioral health strategy is its “Member2Member” peer support program. This initiative connects beneficiaries with fellow members who provide empathetic support and guidance. Addressing social isolation—a common issue among older adults—this peer model is a critical part of SCAN’s effort to deliver whole-person care for seniors by nurturing social connection and emotional health.
The program currently reaches about 10,000 members, who engage in regular phone calls designed to build trust, set goals, and improve emotional well-being. These interactions empower members to increase physical activity, rebuild relationships, or discuss mental health openly with their doctors—key components of whole-person care for seniors.
Expanding Support with Care Navigators and Community Resources
For those with more complex needs, SCAN supplements peer support with care navigators and social workers who provide additional assistance, linking members to community resources that address social determinants of health. This layered approach ensures a comprehensive model of whole-person care for seniors, meeting each member’s unique medical and social needs.
During the COVID-19 pandemic, SCAN expanded its outreach to combat heightened social isolation, resulting in improved member retention and satisfaction. Peer connections have also encouraged more beneficiaries to seek treatment for conditions like urinary incontinence, which can affect mental health and social engagement—demonstrating the power of whole-person care for seniors in addressing interconnected issues.
Looking Ahead: In-Person Support and Closing Care Gaps
SCAN plans to resume in-person peer support once it is safe, which will further enhance its ability to provide whole-person care for seniors, especially for underserved communities. Gelb highlights the importance of culturally and linguistically sensitive peer support in closing gaps for people of color and non-English speakers, groups that often face disparities in behavioral health outcomes.
Conclusion
SCAN Health Plan’s integrated approach exemplifies how health plans can successfully deliver whole-person care by combining medical, behavioral, and social supports. Through innovative assessments, peer connections, and personalized care, SCAN is helping its members achieve better health, stronger social ties, and greater independence.
