Senior Campus Living signed an agreement with Blue Cross and Blue Shield of Maryland yesterday to offer managed care plans at its senior living communities.
Senior Campus Living (SCL) will function much like an HMO. Blue Cross will pay SCL a flat fee each month for each resident who enrolls in MediCareFirst, the Blue Cross Medicare HMO. SCL will be responsible for providing and paying for all health care, including hospitalization.
SCL expects to lose money on the deal, at least in the short term, said Dr. Gary Applebaum, senior vice president and medical director. However, the company hopes to attract residents to its campuses by providing good medical care, he said.
"The development game is where our revenue is," Applebaum said. "This will raise the value of our campuses."
Senior Campus Living already provides doctors at its campuses, who generally are paid fees as they care for residents. In most cases, Applebaum said, the residents are covered by Medicare.
By enrolling in MediCareFirst, which has no monthly premium, residents can expect to save about $1,500 a year in Medigap supplemental premiums and receive some benefits not provided by most Medigap policies, such as some coverage for prescription drugs.
However, as in any HMO, seniors would need approval from their primary care doctor to see a specialist, and they would generally be sent only to specialists in the SCL network. Applebaum said at Charlestown, in Catonsville, where the plan will begin operating in January, SCL has seven full-time doctors and 25 specialists who visit the campus regularly.
Charlestown residents who need hospitalization will generally be sent to nearby St. Agnes HealthCare, he said.
Seniors deciding whether to enroll in an HMO need to balance costs and benefits, said Diane Archer, executive director of the Medicare Rights Center, a New York-based advocacy group.
"Some seniors are very happy in HMOs because they get extra benefits," she said. "Others find they can't get the care they need."
Applebaum said the company felt that by using its own doctors and offering its own or contracted pharmacies, ambulances and other services, it will be able to better manage costs.
Pub Date: 10/21/98