Most people agree on the ideal way to age: healthfully, independently and gracefully.
Advances in medicine have helped more of us live longer. But today, it’s difficult for many Americans to age well. Our fragmented and confusing health systems often forgo prevention-based care in favor of treatment-focused care, leaving the majority of American seniors without the support they need.
As we get older, our healthcare needs evolve and our health goals require a different kind of support. CenterWell, the health care services division of Humana, is making that support available for seniors with integrated care that supports a wide range of needs.
We talked to Dr. Erika Pabo to discuss how CenterWell’s integrated approach to care is creating a better system for supporting the needs of our nation’s seniors.
Dr. Pabo, as a physician, what does it mean to “age well?”
Erika Pabo
Aging well isn’t just about adding years to our lives, it’s about ensuring our later years are fulfilling and that we can live our best lives on our own terms. For most, it means maintaining autonomy, purpose and dignity, while staying as physically and mentally healthy as possible and remaining comfortable in our own homes. In CenterWell’s recent Aging Well in America survey, conducted in partnership with Morning Consult, we found that 66% of Americans—and 78% of those over 65—prioritize independence over longevity when it means being dependent on others.
Unfortunately, our current health system isn’t built to support aging well. My maternal grandmother, who was a feisty and brilliant physician in her own right, started joking in her early 90s that “aging isn’t for everyone, but it beats the alternative.” And in our current ecosystem, she was right, but we can do so much better. I have met many seniors who, despite seeing many doctors, have not been educated on what to expect over the next decade of their lives, how to maximize their ability to live independently, or have been provided the right tools, resources, or programs. Aging well requires practicing preventive care and good daily habits, but individuals can’t do that alone. It requires the right support to start and maintain those habits early, and more support as we need it, so we can maintain that dignity and self-determination at the end of our lives.
What are the biggest barriers facing seniors who want to age well?
Erika Pabo
There are many, but one of the most pressing is access to consistent, preventive care with a primary care physician. More than half of adults over 65 report not regularly seeing their primary care provider. Less than a third of 45–64 year olds report visiting their primary care doctor regularly, which is concerning for their future health. There’s also the lack of quality primary care in medically underserved areas, transportation or mobility issues inhibiting travel for medical care, or exceedingly high healthcare costs. All of these can make it hard for seniors to get the kind of care that supports their goals.
Another barrier is the fragmentation of services and care. As an older adult, it can be challenging to run around town for your healthcare needs, including your doctors’ visits, prescription pick-ups, and lab draws, especially if transportation is limited. This is the invisible ‘tax’ of being a patient in our current system. As a result, seniors may miss doctor’s appointments or experience disruptions in their medications, potentially leading to adverse events. They may also unintentionally avoid or miss recommended preventive screenings, which can lead to delayed diagnoses. In the long run, this may lead to poor health and the development of medical conditions that could have been prevented or better managed, leading to the need for more significant interventions such as more medications, procedures, and hospitalizations, which, in turn, affect both physical and emotional quality of life.
Finally, there is the societal view of aging, with nearly half of Americans believing that society views aging negatively, despite seniors themselves viewing it positively. This disconnect matters because when aging is framed as decline rather than opportunity, it affects how people prepare for it, how policymakers prioritize it, and even how some clinicians engage with older patients. We all need to ask ourselves, and our loved ones: ‘What does aging well mean for us?” If we can define what matters most, we can orient our care towards those goals, which include, for many seniors, living as independently as possible.
CenterWell emphasizes integration across primary care, pharmacy, and home health. Why is that model so critical?
Erika Pabo
Healthcare integration is a significant pillar of aging well. At CenterWell, we’ve intentionally created a care model that brings these services together because that’s how seniors live.
Older adults often manage multiple chronic conditions, with 93% of adults 65 and older living with at least one chronic condition and nearly 80% living with two or more. That complexity demands a connected, interdisciplinary team who knows the patient. When primary care, pharmacy and, at times, home health work as one, we can coordinate interventions and ease burden on patients and caregivers. By relieving seniors of the challenge of navigating a fragmented healthcare system, and instead providing them with whole-person, wraparound support and care coordination, we can help eliminate disruptions in treatment, improve medication adherence, and make substantive improvements in their health outcomes. And, for seniors who are assisted by a caregiver, integrated care makes life simpler for them as well.
What role does value-based care play in making this integration work?
Erika Pabo
It’s essential. Value-based care rewards what matters: better outcomes, not more procedures. It shifts the focus from sick care to preventive, whole-person care. Our seniors benefit when we’re incentivized to help them stay healthy and at home.
Value-based care also makes integration sustainable. For example, when we align incentives across pharmacy, home health and primary care, our clinicians can collaborate more freely. They’re not working in silos but are instead united in their purpose. The result is better preventive care, chronic disease management, health outcomes, and fewer avoidable interventions such as hospitalizations, with lower costs across the system.
How do you know that your approach is effective?
Erika Pabo
The data confirms it. In partnership with Harvard researchers, Humana evaluated outcomes for nearly half a million Medicare Advantage patients in senior-focused primary care models. The results were striking: 17% more primary care visits, 6% fewer hospitalizations, 11% fewer ER visits, and a 10% reduction in 30-day readmissions. And importantly, these models helped narrow racial and income-based disparities in care.
At CenterWell, we’ve seen these results firsthand. Our comprehensive, team-based primary care model reduces avoidable hospital admissions by more than 30% and ER visits by 20%.
What does the future of aging well look like and how do we get there?
Erika Pabo
The future of aging well has two distinct but related needs: transform the healthcare system and empower the individual. At the systemic level, we need a proactive, integrated health care model that incentivizes healthy outcomes. We can do this by improving the continuity of care across providers – from primary care to pharmacy and home health – and incentivize physicians with financial arrangements where success is defined by patient outcomes, not the volume of services ordered.
At the same time, we need to improve how we support seniors. That means emphasizing primary care and training providers on the specific healthcare needs of older adults. We need to expand access for seniors in underserved and rural communities and have supports and services in place to address social and behavioral health. In addition, we need to ask ourselves, and our patients, what matters most for aging well, and orient our goals around that shared purpose.
Aging is inevitable, but aging well requires intentionality, foresight and the right support system. If we invest in the right systems and support people with care that’s personal, connected and preventive, we will set the path toward healthier and more fulfilled seniors, which is a future we aspire to create for ourselves and our loved ones.
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