Skip to Main Content

Senior Care: Better Health Care for the Golden Years

Dr. Misha Rhodes talks about better patient-centered care for seniors.
Season 19 Episode 3 Length 27:16 Premiere: 10/15/23

About

Join host Dr. Wayne Tuckson, a colorectal surgeon, as he interviews experts from around the state to discuss health topics important to Kentuckians.


Funding for this program is made possible in part by:


About the Host

A native of Washington, D.C., Dr. Wayne Tuckson is a retired colon and rectal surgeon based in Louisville. For more than 20 years, he has served as host for Kentucky Health, a weekly program on KET that explores important health issues affecting people across the Commonwealth. A graduate of Howard University School of Medicine, Tuckson is a past president of the Greater Louisville Medical Society and is a recipient of the Community Service Award from the Kentucky Medical Society, the Thomas J. Wallace Award for “Leadership in Promoting Health Awareness and Wellbeing for the Citizens of Jefferson County” given by the City of Louisville and the Lyman T. Johnson Distinguished Leadership Award given by the Louisville Central Community Centers.

CMO of Louisville-based Nonprofit Discusses the Benefits of a Value-Based Health Care Model

Here are three takeaways from an episode of Kentucky Health examining health care for senior citizens. Host Dr. Wayne Tuckson welcomes Dr. Misha Rhodes, chief medical officer for the nonprofit CenterWell system serving Louisville-area seniors.

1) Everyone as they age will develop ailments and face an increased risk of having a chronic disease. But the current health care model in America is not designed to treat an aging population, which results in poor quality of care and inefficiencies.

“The way I look at it now is primary care is a one-size-fits-all (model),” Dr. Rhodes says. While pediatrics has its own standards of care designed to treat children with frequent checkups, once a person reaches their mid-teens, he or she transitions into primary care and largely stays within that framework for the rest of the lifespan.

“It’s the same for everybody,” Rhodes says. “You get the same amount of time with your providers, you get the same issues addressed, and for the most part, it’s fairly transactional – when I’m sick, then I go in. There’s not a lot of preventative time spent to try to keep people healthy.”

Rhodes contends that an aging population needs more personalized care focused on the myriad concerns that every person will encounter during the last decades of life. She says the existing health care model should also devote more resources to preventive care and allocate more time for doctor-patient interaction during an appointment.

“For most traditional primary care practices these days, you may have 10- to 15-minute appointments,” she explains. “By the time you actually get into the room and see the patient, that time is cut even further short. And you hear patients say, ‘I really didn’t get a chance to talk about what I wanted to talk about.’”

At the core of our current health care system and how it operates is what is known as fee-for-service, Rhodes says. That’s where patients schedule appointments with providers to address a particular health issue – be it a case of flu, a broken wrist, or something else – and then pay for treatment of that problem. Aside from an annual physical, patients rarely engage their primary care doctors or nurses with any other request.

“It’s a transactional relationship,” Rhodes concludes. She believes that fee-for-service drives primary care providers to see as many patients as possible to generate profits in their practice, rather than spend more time with each patient and implement a more comprehensive and individualized approach.

In recent years, a model called concierge care has grown in popularity among patients who can afford to access it. With concierge care, patients “buy-up” services beyond their Medicare or insurance limits and receive longer appointment times, on-call services, and other privileges. Rhodes acknowledges the benefits of concierge care for wealthy seniors, but she believes they should be made available to everyone.

2) Shifting toward a “value-based” health care model will help senior patients improve their overall wellness and catch more ailments in early stages. 

This value-based model focuses outcomes, Rhodes explains. “Fee-for-service is about, ‘How many patients can I see in a day to be able to meet my quotas or business needs,’ and with value-based care, it’s about what’s the actual quality? Are we having the outcomes we need to have? Are we keeping patients out of the hospital? Are we keeping them healthy? And are they staying at home and having a better quality of life?”

Instead of relying on fee-for-service payments, the value-based model compensation structure rewards providers for meeting certain metrics of wellbeing for each patient. “At the end of the day, if patients do well and you’re able to address the evidence-based measures that we know affect quality outcomes, then you are rewarded for that,” Rhodes says.

Patients who enroll in a value-based model encounter “a little bit of a mind-shift,” Rhodes says. “A lot of patients are used to, ‘I come in only when I’m sick,’ and what we are educating patients on is that we want to see you more frequently. We don’t just want to see you when you’re sick, because by the time you are sick, we may be too far behind to really make an impact.”

Rhodes concedes that medical providers used to a fee-for-service basis also have a period of adjustment when shifting to a value-based model. One significant change concerns documentation, she says. Rhodes recalls her own medical training and how most primary care physicians came to rely on a fast and sometimes abbreviated process of note-taking when seeing a large number of patients. Under the value-based model, she says providers are asked to write longer, more detailed notes about each patient and visit.

“It doesn’t have to be three pages of notes, but to document specifically how well or how ill your patient is,” Rhodes explains. “I like to say it’s telling the patient’s story.”

3) The CenterWell model offers a health care paradigm that results in better patient outcomes and potentially can be scaled up.

The health care model at CenterWell is value-based, Rhodes says. It operates in 15 states across the U.S., and the three Louisville branches are open to any senior citizen in the metro area (including southern Indiana) with Medicare. She adds that persons under age 65 who are on Medicare can also use CenterWell, and there are no restrictions on pre-existing conditions.

The facility houses an entire team of medical professionals to provide comprehensive care for patients, Rhodes explains. “For our team within primary care, we have our physician, our nurse practitioner. Within the center, patients will have support from a social worker, behavioral health specialist. We’ll have a registered nurse that helps do a lot of patient education around chronic diseases, and then of course we have our wonderful medical assistants and front office staff and administrators,” she says.

In addition, Rhodes says doctors at CenterWell will refer patients to outside specialists for care when warranted and also provide transportation to those appointments. That’s critical for many patients who may not have the physical ability to drive or the financial means to secure a ride.

“We try not to let those social determinants of health be a barrier to someone’s health outcomes,” she says.

The model at CenterWell aims to provide comprehensive care for each senior patient, and Rhodes says their primary care physicians are trained to treat most diseases. If a referral to an outside provider is needed, the staff at CenterWell will schedule one – and they are not limited to any specific health care network when doing so.

Using this value-based model, Rhodes says physicians and nurse practitioners treat around 700 to 750 patients at CenterWell. The time allotted for office visits ranges from 45 to 60 minutes for an initial visit and 30 minutes for follow-ups. She says these visits are scheduled based on each individual’s health care needs. Relatively healthy patients may visit two to four times per year, while those with chronic diseases will visit more often.

Rhodes recalls a Louisville radio host who, after learning about CenterWell, labeled its model “Oprah-level care.” She agrees with that description and says she hopes the value-based model will expand in the future to serve more adults under age 65 who are not on Medicare.

“Seniors deserve to have great care,” she concludes. “You deserve to be treated like family when you come in the door, and you deserve to have time for someone to listen to you.”

Sponsored by:

Kentucky LifeKentucky Life

Season 19 Episodes

Sustainability: Government, Corporate and Public Cooperation

S19 E17 Length 26:43 Premiere Date 02/18/24

Federally Qualified Health Centers: More Than a Safety Net

S19 E16 Length 26:40 Premiere Date 02/11/24

Government Sponsored Health Insurance: Value and Promise

S19 E15 Length 26:32 Premiere Date 02/04/24

The Unspoken and Misunderstood Stigma of Eating Disorders

S19 E14 Length 27:31 Premiere Date 01/28/24

Bariatric Surgery: Intervention for a Chronic Illness

S19 E13 Length 27:29 Premiere Date 01/21/24

Suicide Prevention: The First Step to Mental Health

S19 E12 Length 27:31 Premiere Date 01/14/24

Rural Healthcare: Crisis or Opportunity on the Horizon

S19 E11 Length 27:31 Premiere Date 01/07/24

Taste Not Waste: Making Nutritious Dishes from Leftover Food

S19 E10 Length 27:19 Premiere Date 12/17/23

Breast Cancer: Innovations Beyond Screening

S19 E9 Length 27:23 Premiere Date 12/10/23

Heart Failure: Prevention and Treatment

S19 E8 Length 27:23 Premiere Date 11/19/23

Better Cancer Screening: The Answer Is In the Blood

S19 E7 Length 27:25 Premiere Date 11/12/23

Alzheimer's Disease and Related Dementia

S19 E6 Length 27:24 Premiere Date 11/05/23

Cannabis: The Hype, the Reality, and the Potential

S19 E5 Length 26:55 Premiere Date 10/29/23

Sleep Apnea: New Treatments

S19 E4 Length 27:14 Premiere Date 10/22/23

Senior Care: Better Health Care for the Golden Years

S19 E3 Length 27:16 Premiere Date 10/15/23

Pelvic Prolapse

S19 E2 Length 27:32 Premiere Date 10/08/23

Climate Change and Insect Vectors

S19 E1 Length 26:31 Premiere Date 10/01/23

See All Episodes

caret down

TV Schedules

Jump to Recent Airdates

Upcoming

Sustainability: Government, Corporate, and Public Cooperation - S19 E17

Can we meet the needs of today without compromising the environment for future generations? Sumedha Rao talks about sustainability. A 2024 KET production.

  • Wednesday February 21, 2024 11:00 am ET on KETKY
  • Wednesday February 21, 2024 10:00 am CT on KETKY
  • Friday February 23, 2024 1:30 pm ET on KETKY
  • Friday February 23, 2024 12:30 pm CT on KETKY
  • Sunday February 25, 2024 12:30 am ET on KETKY
  • Saturday February 24, 2024 11:30 pm CT on KETKY
  • Sunday February 25, 2024 7:00 am ET on KET2
  • Sunday February 25, 2024 6:00 am CT on KET2
  • Sunday February 25, 2024 9:00 am ET on KETKY
  • Sunday February 25, 2024 8:00 am CT on KETKY

Markey Cancer Center: Changing Cancer Treatment in Kentucky and the World - S19 E18

Surgical oncologist Dr. Mark Evers discusses new trends in cancer treatment. A 2024 KET production.

  • Sunday February 25, 2024 1:30 pm ET on KET
  • Sunday February 25, 2024 12:30 pm CT on KET
  • Sunday February 25, 2024 5:30 pm ET on KETKY
  • Sunday February 25, 2024 4:30 pm CT on KETKY
  • Monday February 26, 2024 2:00 pm ET on KET2
  • Monday February 26, 2024 1:00 pm CT on KET2
  • Wednesday February 28, 2024 11:00 am ET on KETKY
  • Wednesday February 28, 2024 10:00 am CT on KETKY
  • Friday March 1, 2024 1:30 pm ET on KETKY
  • Friday March 1, 2024 12:30 pm CT on KETKY
  • Sunday March 3, 2024 12:30 am ET on KETKY
  • Saturday March 2, 2024 11:30 pm CT on KETKY
  • Sunday March 3, 2024 9:00 am ET on KETKY
  • Sunday March 3, 2024 8:00 am CT on KETKY

Cannabis: The Hype, the Reality, and the Potential - S19 E5

The study of marijuana is hampered by state and federal regulations, and limited funding. What data is known about safety, efficacy and long-term effects? Dr. Shanna Babalonis talks about the changing role of marijuana in society and healthcare. A 2023 KET production.

  • Sunday March 3, 2024 5:30 pm ET on KETKY
  • Sunday March 3, 2024 4:30 pm CT on KETKY
  • Monday March 4, 2024 2:00 pm ET on KET2
  • Monday March 4, 2024 1:00 pm CT on KET2
  • Wednesday March 6, 2024 11:00 am ET on KETKY
  • Wednesday March 6, 2024 10:00 am CT on KETKY
  • Friday March 8, 2024 1:30 pm ET on KETKY
  • Friday March 8, 2024 12:30 pm CT on KETKY
  • Sunday March 10, 2024 12:30 am ET on KETKY
  • Saturday March 9, 2024 11:30 pm CT on KETKY
  • Sunday March 10, 2024 9:00 am ET on KETKY
  • Sunday March 10, 2024 8:00 am CT on KETKY

Alzheimer's Disease and Related Dementia - S19 E6

Neurologist Dr. Gregory Cooper talks about dementia and Alzheimer's disease. A 2023 KET production.

  • Sunday March 10, 2024 5:30 pm ET on KETKY
  • Sunday March 10, 2024 4:30 pm CT on KETKY
  • Monday March 11, 2024 5:30 am ET on KET2
  • Monday March 11, 2024 4:30 am CT on KET2
  • Monday March 11, 2024 2:00 pm ET on KET2
  • Monday March 11, 2024 1:00 pm CT on KET2
  • Wednesday March 13, 2024 11:00 am ET on KETKY
  • Wednesday March 13, 2024 10:00 am CT on KETKY
  • Friday March 15, 2024 1:30 pm ET on KETKY
  • Friday March 15, 2024 12:30 pm CT on KETKY
  • Sunday March 17, 2024 12:30 am ET on KETKY
  • Saturday March 16, 2024 11:30 pm CT on KETKY
  • Sunday March 17, 2024 7:00 am ET on KET2
  • Sunday March 17, 2024 6:00 am CT on KET2
  • Sunday March 17, 2024 9:00 am ET on KETKY
  • Sunday March 17, 2024 8:00 am CT on KETKY

Climate Change: A Change in Our Health - S19 E19

Meteorologist Tawana Andrew talks about how climate change is affecting our health. A 2024 KET production.

  • Sunday March 17, 2024 1:30 pm ET on KET
  • Sunday March 17, 2024 12:30 pm CT on KET
  • Sunday March 17, 2024 5:30 pm ET on KETKY
  • Sunday March 17, 2024 4:30 pm CT on KETKY
  • Monday March 18, 2024 2:00 pm ET on KET2
  • Monday March 18, 2024 1:00 pm CT on KET2
  • Wednesday March 20, 2024 11:00 am ET on KETKY
  • Wednesday March 20, 2024 10:00 am CT on KETKY
  • Friday March 22, 2024 1:30 pm ET on KETKY
  • Friday March 22, 2024 12:30 pm CT on KETKY
Jump to Upcoming Airdates

Recent

Sustainability: Government, Corporate, and Public Cooperation - S19 E17

  • Monday February 19, 2024 2:00 pm ET on KET2
  • Monday February 19, 2024 1:00 pm CT on KET2
  • Sunday February 18, 2024 5:30 pm ET on KETKY
  • Sunday February 18, 2024 4:30 pm CT on KETKY
  • Sunday February 18, 2024 1:30 pm ET on KET
  • Sunday February 18, 2024 12:30 pm CT on KET

Federally Qualified Health Centers: More Than a Safety Net - S19 E16

  • Sunday February 18, 2024 9:00 am ET on KETKY
  • Sunday February 18, 2024 8:00 am CT on KETKY
  • Sunday February 18, 2024 7:00 am ET on KET2
  • Sunday February 18, 2024 6:00 am CT on KET2
  • Sunday February 18, 2024 12:30 am ET on KETKY
  • Saturday February 17, 2024 11:30 pm CT on KETKY
  • Friday February 16, 2024 1:30 pm ET on KETKY
  • Friday February 16, 2024 12:30 pm CT on KETKY
  • Wednesday February 14, 2024 11:12 am ET on KETKY
  • Wednesday February 14, 2024 10:12 am CT on KETKY
  • Monday February 12, 2024 2:00 pm ET on KET2
  • Monday February 12, 2024 1:00 pm CT on KET2
  • Sunday February 11, 2024 5:30 pm ET on KETKY
  • Sunday February 11, 2024 4:30 pm CT on KETKY
  • Sunday February 11, 2024 1:30 pm ET on KET
  • Sunday February 11, 2024 12:30 pm CT on KET

Government Sponsored Health Insurance: Value and Promise - S19 E15

  • Sunday February 11, 2024 9:00 am ET on KETKY
  • Sunday February 11, 2024 8:00 am CT on KETKY
  • Sunday February 11, 2024 7:00 am ET on KET2
  • Sunday February 11, 2024 6:00 am CT on KET2
  • Sunday February 11, 2024 12:30 am ET on KETKY
  • Saturday February 10, 2024 11:30 pm CT on KETKY
  • Friday February 9, 2024 1:30 pm ET on KETKY
  • Friday February 9, 2024 12:30 pm CT on KETKY
  • Wednesday February 7, 2024 11:22 am ET on KETKY
  • Wednesday February 7, 2024 10:22 am CT on KETKY
  • Monday February 5, 2024 2:00 pm ET on KET2
  • Monday February 5, 2024 1:00 pm CT on KET2
  • Sunday February 4, 2024 5:30 pm ET on KETKY
  • Sunday February 4, 2024 4:30 pm CT on KETKY
  • Sunday February 4, 2024 1:30 pm ET on KET
  • Sunday February 4, 2024 12:30 pm CT on KET

The Unspoken and Misunderstood Stigma of Eating Disorders - S19 E14

  • Sunday February 4, 2024 9:00 am ET on KETKY
  • Sunday February 4, 2024 8:00 am CT on KETKY
  • Sunday February 4, 2024 7:00 am ET on KET2
  • Sunday February 4, 2024 6:00 am CT on KET2
  • Sunday February 4, 2024 12:30 am ET on KETKY
  • Saturday February 3, 2024 11:30 pm CT on KETKY
  • Friday February 2, 2024 1:30 pm ET on KETKY
  • Friday February 2, 2024 12:30 pm CT on KETKY
  • Wednesday January 31, 2024 11:00 am ET on KETKY
  • Wednesday January 31, 2024 10:00 am CT on KETKY
  • Monday January 29, 2024 2:00 pm ET on KET2
  • Monday January 29, 2024 1:00 pm CT on KET2
  • Sunday January 28, 2024 5:30 pm ET on KETKY
  • Sunday January 28, 2024 4:30 pm CT on KETKY
  • Sunday January 28, 2024 1:30 pm ET on KET
  • Sunday January 28, 2024 12:30 pm CT on KET

Bariatric Surgery: Surgical Intervention for a Chronic Illness - S19 E13

  • Sunday January 28, 2024 9:00 am ET on KETKY
  • Sunday January 28, 2024 8:00 am CT on KETKY
  • Sunday January 28, 2024 7:00 am ET on KET2
  • Sunday January 28, 2024 6:00 am CT on KET2
  • Sunday January 28, 2024 12:30 am ET on KETKY
  • Saturday January 27, 2024 11:30 pm CT on KETKY
  • Friday January 26, 2024 1:30 pm ET on KETKY
  • Friday January 26, 2024 12:30 pm CT on KETKY
  • Wednesday January 24, 2024 11:04 am ET on KETKY
  • Wednesday January 24, 2024 10:04 am CT on KETKY
  • Monday January 22, 2024 2:00 pm ET on KET2
  • Monday January 22, 2024 1:00 pm CT on KET2
  • Sunday January 21, 2024 5:30 pm ET on KETKY
  • Sunday January 21, 2024 4:30 pm CT on KETKY
  • Sunday January 21, 2024 1:30 pm ET on KET
  • Sunday January 21, 2024 12:30 pm CT on KET

Suicide Prevention: The First Step to Mental Health - S19 E12

  • Sunday January 21, 2024 9:00 am ET on KETKY
  • Sunday January 21, 2024 8:00 am CT on KETKY
  • Sunday January 21, 2024 7:00 am ET on KET2
  • Sunday January 21, 2024 6:00 am CT on KET2
  • Sunday January 21, 2024 12:30 am ET on KETKY
  • Saturday January 20, 2024 11:30 pm CT on KETKY
Top

Explore KET