2019 Report to Our Communities
Our Community Report is a look back at the past year. We would be remiss, however, not to acknowledge the impact of COVID-19 in 2020. Please know that we remain senior-centered. We remain focused on our mission. And we continue to build on the accomplishments of the last year to continually improve how we serve and support seniors. It is in this spirit that we invite you to review our 2019 Community Report: In Celebration of Centenarians.
Meet more SCAN members who are 100 and older throughout this report and learn about our “stages: 100 over 100” campaign on page 10.
When SCAN was founded in 1977, it was seniors who took the lead, bringing together the services and support they needed to remain healthy and independent. SCAN looks a little different today, but the mission remains the same. And, as incoming CEO, I’m very proud to be stepping into this organization at this point in time.
While we are focused on the future for SCAN and for senior care, I want to acknowledge the work of my predecessor, Chris Wing, and the team at SCAN that accomplished so much in 2019. This report highlights just some of their work—in particular, the organization’s commitment to person-centered innovation.
SCAN reached a high-water mark when the health plan membership hit 215,000 by year’s end. This growth inspires us to help even more older adults remain healthy and independent.
At the same time, it challenges us: How do we continue to deliver care and services that speak directly to our members’ needs, when those needs are as diverse as the members themselves?
SCAN has stepped up to meet this challenge with the strategic use of technology, innovative processes, and productive partnerships to ensure that what matters most to older adults remains at the center of everything we do.
That means the personal touch we’re known for also remains front and center. As valuable as a Fitbit, a text or data-driven outreach can be, none can replace bringing a cake to celebrate a 104-year-old member on her birthday, helping seniors share their life stories in a Guided Autobiography workshop, or calling to see how a member is doing after coming home from the hospital. These moments matter.
We look forward to delivering many more such moments in the years to come.
Sachin H. Jain, MD, MBA, FACP
President and CEO, SCAN Group and SCAN Health Plan
For the third consecutive year, we earned 4.5 stars in Medicare’s 5-star quality rating system.
*Star rating applies to all plans offered by SCAN Health Plan except SCAN Healthy at Home and VillageHealth. Star ratings are calculated each year and may change from one year to the next.
Our score continues to improve each year—we’re in the top 9 percent of Gallup’s client companies nationwide!
As reported in Medicare & You, 2020
Building and maintaining relationships: Membership growth and member retention are equally important.
As of December 2019
Gained during one of the most successful
Annual Enrollment Periods in our history!
We don’t work to win awards, but we always appreciate when our efforts to provide quality service and care to our members are validated. In the past year, we were recognized with these honors:
U.S. News &
Best Insurance Companies
for Medicare Advantage 2020
STEVIE® Gold Sales & Customer Service Award
Customer Service Department
of the Year
STEVIE® Silver Sales & Customer Service Award
Customer Service Management Team
STEVIE® Gold American Business Award
Customer Service Department and Management Team of the Year
ICMI Awards Finalist
Best Medium Contact Center
Best Contact Center Culture
While we all may face similar challenges as we age, our needs, preferences and expectations are as individual as we are. That’s exactly what a person-centered approach takes into account—and why that’s been our approach from day one. SCAN has always believed that healthcare can and should fit into our members’ lives, on their terms. An important part of this is recognizing and addressing the other factors that impact a person’s health: income, nutrition, housing and transportation, to name just a few of the social determinants of health. To be truly effective, healthcare must be holistic, and health coverage must be flexible.
Whether a Medicare Advantage Prescription Drug (MAPD) plan or one of our Special Needs Plans (SNPs), all SCAN plans are designed to ensure our members have access to high-quality care that’s affordable, too.
2020 | Percent of SCAN members who pay:
$0 Inpatient hospitalization 81%
$0 PCP office visit 85%
$0 Monthly premium 89%
$0 Tier 1 drugs 96%
Plus, members have access to benefits beyond what Medicare alone covers.
2020 | Percent of SCAN members who have:
$0 Telehealth 93%
Fixed-cost hearing aids 97%
$0 Gym Membership 99%
$0 Transportation 99%
$0 Meal benefit 99%
Chiropractic benefit 99%
Vision care 99%
In 2019, Medicare allowed health plans more flexibility in benefit design, enabling us to offer services and tools that are better tailored to members’ needs and lifestyles.
While Health Risk Assessments (HRAs) are required for Special Needs Plan members, we think it’s important to get this information for all our members. After piloting “HRA for All” in the Fall of 2018, we rolled it out more broadly in 2019—and dove deeper into the results. Most members who completed an HRA reported that they were in good or better health. That’s great to hear! Some members, however, reported issues related to social determinants of health and other complex issues that impact their well-being and independence. Much of SCAN’s work in 2019 focused on identifying and addressing these challenges.
HRA RESULTS | Fall 2018 through Dec. 2019
81% members completed an HRA
77% reported being in good or better health
36% said that pain interfered with their daily life
35% feel lonely
28% have trouble with balance or walking, or had fallen recently
15% do not have friends or family willing to help when needed
7% couldn't get food when needed
2% are homeless or housing insecure
We appreciate the notes many members add to the margins of their written survey responses. They remind us that behind the data are real people with lives and stories to tell. And priorities of their own. One member thought it important we know that she has “5 children, 10 grandchildren and 7 great grandchildren: a full house!” And, clearly, a full heart.
Who better to identify the care and services that would best support high-needs members than those seniors themselves? In 2019, several initiatives benefited from the direct involvement of these members.
We identified these participants mainly through their HRA responses, and invited them to share their experience and insight so we could better understand and address such issues as chronic pain and the challenges of living with multiple complex medical and social needs. We held focus groups, made phone calls, and even visited members in their homes to ensure we got the full picture.
Their involvement in this process helps ensure that the benefits, programs and services we design are truly of value to those who need them.
“Thank you for asking me about this. You made me feel brave enough to talk to my doctor about my pain issues.”
– 72-year-old SCAN member Dorothy
SCAN has always taken pride in our award-winning Member Service. As healthcare has become increasingly complex, we challenged ourselves to make it less complicated for our members. This is where technology has enabled us to step up our service game. The result is a healthcare experience that is more personalized and less complicated.
It’s more personalized because call technology connects each member directly with the team specially trained to work with the member’s medical group. It’s less complicated because our team runs interference with the medical group—tracking down authorizations, getting answers and generally ensuring all parties are on the same page. Our team members worked with The Ritz-Carlton Leadership Center, a legendary brand that fosters a culture known to follow every issue through to resolution.
We started rolling out this tech-based approach in January 2019, and members aren’t the only ones who’ve noticed. Our service team is thrilled to provide this added support for members. And our provider partners appreciate the collaboration on behalf of their patients.
“The question I hear most from the SCAN team is: ‘What else can we do for this member?’ I’m honored to have the opportunity to work with such a professional, caring team.”
– Medical Group Patient Services Advocate
SCAN Senior Advocates—SCAN members who are part-time SCAN employees—aim to call every member on their birthday. When we passed the 200,000-member mark early in 2019, however, making all those birthday calls became a challenge. So we invited employees from other departments to join the phone call brigade. Now more members are hearing “Happy Birthday,” and more employees are getting a personal reminder of who it is they work for every day.
“The first member I called told me that, even though she was bedridden, she was grateful for living another year. I was moved to tears by her story and took away something very special from our conversation: No matter what, be grateful and never take life for granted.”
– Christi Avila, Member Billing Representative (pictured)
In 2019, there were over 80,000 centenarians living in America—and more than 300 of them were SCAN Health Plan members. The “stages: 100 over 100” campaign is a digital docuseries we created to shine the spotlight on some of these members.
SCAN Senior Advocates began making birthday visits in 2015, welcoming these members into the SCAN 100+ Club in person. Many times they are joined by family and friends. Other times it is our honor and great pleasure to be the ones to spend time with them on their special day.
As we schedule these visits, we ask if we can bring photographer Robert Duron along to document the event. More often than not, they’re thrilled to have us capture their milestone on film and are happy to share their insights.
We hope the “stages” campaign will inspire others to see what we see every day: the beauty, dignity and joy in aging.
SCAN works with a number of medical groups throughout our service area. Doing so gives our members a choice of doctors and providers, which we know they appreciate. The challenge is in ensuring a consistent quality experience among the groups that still allows for and encourages individuality. After all, these doctors and their staffs are the face of SCAN for our members. They know their communities, their patients and their challenges best. Listening to these experts enabled us to introduce several new approaches to care delivery in 2019, resulting in improved member outcomes and greater provider satisfaction.
Since SCAN introduced Provider Integration (PI) in 2013, the program has brought together some of SCAN’s biggest and best-performing medical groups to collaborate to solve clinical and operational challenges. The goal then, as now, is to create a system that delivers high-quality care and service to senior patients. This unique environment, in which we’re sharing best practices and exploring new approaches, has set the stage for innovations that are improving care for our members, including using telehealth to expand access to mental health services.
164,000 SCAN members, or nearly 80% of our total member population, are represented by groups participating in Provider Integration.
At one medical group in the Antelope Valley—a remote area where there are few mental health specialists—senior patients can now talk with a psychiatrist virtually. Appointments are held at their primary care doctor’s office, where they are familiar and comfortable, and, importantly, the technology is set up for them. Initial results are promising. Wait times for an appointment with a psychiatrist are down significantly, and so is the appointment no-show rate. We’re testing variations of this SCAN Group pilot with a few of our partner medical groups who have their own unique challenges delivering behavioral healthcare. By employing this technology more broadly, we can provide help and hope to seniors struggling with mental health issues.
“It’s helped me a lot just to know that [the psychiatrist] is available—that I’ve got someone to talk to if I can’t unscramble the depression on my own.”
– 82-year-old SCAN member Loretta
In 2019, the Office Staff Training (OST) program continued to introduce the people on the front lines of caring for SCAN members—doctors and their staffs—to information and tools that can improve experiences and care for their older patients. This year, a new class, Improving Health Outcomes, was added to the roster of 22 mix-and-match courses available at no charge to the medical groups that serve SCAN members. In March, SCAN’s OST trainers once again shared their expertise in a Train-the-Trainer session. These popular, high-energy workshops give group management the tools and information they need to deliver or reinforce OST courses at their sites.
OFFICE STAFF TRAININGS | 2019
4,764 office staff members participated
498 physicians participated
43 Train-the-Trainer particpants
20 medical groups, representing 30% of SCAN's membership
147 classes held
Most popular course
HEAT: Maintaining Quality in Difficult Situations
“This training offered valuable perspective, and provided me with tools and insights to better assist my senior population.”
– OST participant
The best ideas are those that can benefit others. We are always on the lookout for ways to share successful ideas with our members and their caregivers.
Adapted from the program developed by the Johns Hopkins School of Nursing
For 83-year-old SCAN member Betty, walking had become so painful that it was hard for her to make her way around her Riverside home. Fortunately, SCAN is testing the CAPABLE program in Betty's medical group to address both the functional and medical issues that make it difficult for seniors to stay in their homes. With the help of "Team Betty"—SCAN social worker, an occupational therapist, and a home repair professional who installed a hand railing—Betty learned positive ways to manage her pain as well as exercises to build her strength, and she is now healthier and happier in her home.
Click the image to watch SCAN member Ana’s CAPABLE success story.
“The CAPABLE program is thinking outside the box; it shows us that small things can make a big difference.”
– Melissa Cruz, Occupational Therapist for SCAN CAPABLE
Robert Wood Johnson Grant with the Center to Advance Consumer Partnership (CACP)
Founded by the Commonwealth Care Alliance, the Center to Advance Consumer Partnership (CACP) is looking to define a better way to serve individuals who have complex medical and social needs. It’s what we’ve been doing for more than 40 years—and we’re always looking for ways to do better. The CACP is bringing a comprehensive structure to the process that, importantly, ensures consumers—SCAN members—are part of the solution. The work began in Q4 of 2019 and will continue through 2020 alongside two of our provider partners.
“Through projects like CACP and CAPABLE, we are gaining a deeper understanding of members’ needs, and creating a system that helps members with complex conditions so they can safely age in place.”
– Romilla Batra, MD, SCAN Chief Medical Officer
SCAN’s mission is to improve the lives of seniors, regardless of plan membership. By supporting our communities through funding, education and direct services, we’re able to help underserved seniors enjoy a better quality of life.
Total amount SCAN spent on community services in 2019, including Independence at Home (IAH) and other community programs
Seniors and their caregivers served through IAH, whether connected to government programs, assisted via our resource and referral line, or provided direct services through one of our hallmark programs.
Events Sponsored by IAH to provide support, education and awareness, including health fairs and Trading Ages presentations.
Thanksgiving meals delivered
Feeling connected to others is crucial to a senior’s emotional and physical well-being, and ultimately to their ability to stay in their homes. Last year, caring VAA volunteers made personal connections with hundreds of seniors, offering company, conversation and the reassurance that they’re valued members of the community.
To help prepare a workforce that will be able to meet the requirements of a growing number of seniors, SCAN awarded $50,000 in scholarships to 10 students at Long Beach State University. Representing a number of different majors, all are committed to a career in the aging services field. In developing the scholarship program, we made sure that it included a service component to give these students real-life experience working with and caring for older adults.
Total grants and sponsorships
SCAN Community Giving supports nonprofit organizations that deliver vital services to the most vulnerable seniors. In 2019 our giving included:
Senior Support Service grants
Emergancy Assistant grants
Donations and Sponsorships
We welcome opportunities to share what we’ve learned, wherever it can be a catalyst for advancing senior healthcare and improving the lives of older adults.
Good news is worth sharing! The Insights program, Independence at Home’s unique approach to behavioral health services, has helped improve mental healthcare for hundreds of isolated seniors and their caregivers. Insights brings licensed therapists to clients in their own homes, in their own languages and at no cost. The program was published in the July 2019 issue of the prestigious Journal of American Geriatrics Society.
The Insights program successes:
SCAN executives and other staff shared knowledge, perspectives and expertise on a variety of topics at speaking engagements in 2019. Some of their most popular subjects: addressing social determinants of health, using technology to build empathy, and overcoming medication management challenges.
2019 speaking engagements included:
American Geriatrics Society
Annual Scientific Meeting
American Society on Aging
Aging in America Conference
America's Health Insurance Plans
Consumer & Digital Health Conference
National Conferences on Medicare, Medicaid
and Dual Eligibles
California Association of Long Term Care Medicine
Leadership & Management in Geriatrics
Healthcare Leadership Council
Capitol Hill briefing
Special Needs Plans Alliance
California Pharmacists Association
Western Pharmacy Exchange
Virtual reality (VR), the innovative technology best known for making video game fantasy seem real, now brings to life some of the all-too-real challenges many seniors face every day. In 2019, we rolled out an updated version of SCAN’s popular Trading Ages senior sensitivity training. It uses VR technology to immerse participants in real-life environments, situations and interactions that simulate impaired hearing, limited vision, memory loss and other age-related issues. It’s an up-close-and-personal experience that can give participants both insight and empathy, which informs how they serve and support seniors.
All 400 or so Long Beach firefighters took part in Trading Ages at the end of 2019, marking the first time the program had been delivered on such a large scale. “We always try to connect with the people we are serving in any situation,” said Long Beach Fire Chief Xavier Espino. “With Trading Ages, our emergency response teams are coming away with important insight into some of the challenges seniors face, which will enable us to respond with even greater empathy.”