Based Healthy Aging Programs

Transcription

1 To improve the lives of millions of older adults, especially those who are vulnerable and disadvantaged. Building a Delivery System for Evidence- Based Healthy Aging Programs Sue Lachenmayr, National Council on Aging Stephanie Hull, Maryland Department of Aging Tina Zsenak, New Jersey Department of Health & Senior Services September 2011

2 Today s Discussion Understand AoA s vision for and impact of evidencebased programs Understand the role of evidence-based programs in the full rebalancing vision Learn strategies to partner with healthcare organizations and promote referral to healthy aging programs and leverage funding streams to sustain healthy aging programs See evidence-based programs as an essential service providing individuals with skills to maintain independence, manage chronic disease, and improve quality of life

3 Why Fund EBPs? More than 1.7 million Americans die of a chronic disease each year 91% of older adults have at least one chronic condition; 73% have at least two Among older adults with 2+ chronic conditions: 76% report being limited in function 17% report being frequently depressed RWJF, 2009

4 Health Promotion and Disease Prevention Work Longer life Reduced disability Later onset Fewer years of disability prior to death Fewer falls Improved mental health Positive effect on depressive It s never too late to start it s always too early to stop! symptoms, increased social connectedness Delay in loss of cognitive function Lower health care costs

5 Nationally Recognized EBPs PHYSICAL ACTIVITY Arthritis Exercise EnhanceFitness Fit and Strong Healthy Moves Active Living Every Day SELF-MANAGEMENT CDSMP (English/Spanish) DSMP (English/Spanish) EnhanceWellness DEPRESSION MANAGEMENT Healthy IDEAS PEARLS FALL RISK REDUCTION A Matter of Balance Stepping On (fall risk) Tai Chi Medication Management Medication Management Improvement System (MMIS)

6 Evidence-Based Program Basics Programs tested in random-controlled studies, then translated and tested in community settings Endorsed by the U.S. Administration on Aging Meet evidence-based criteria Proven effective with older adults Demonstrate significant outcomes/cost savings Trained and certified volunteer leaders and/or staff ensure effective program delivery Fidelity monitoring ensures quality and adherence to program principles and model Take Control of Your Health

7 Cross-Cutting Themes Consumer-directed tools for empowerment and self-management Patient activation skills to manage chronic conditions Improved communication skills when talking with health care providers Improved medication management Cross-referral to multiple EBPs for continued social interaction and support Key component of bundled support services

8 Person Centered Service Network CDSMP DSMP AMOB Other EBPs ADRD and Caregiver Support Medicare Benefits Counseling and Enrollment Person and Caregiver ADRC/AAA Intake, Assessment Enrollment, Care Management I&R Care Transitions Meals and Transportation Veterans Directed HCBS 8

9 Maine HCBS for Care Transitions Volunteering Food Access Advocacy/paperwork assistance ME Insurance Emergency Jan-June 2011 Funding Prescription Coverage Caregiver Assistance Transportation Memory Concerns Social concerns Falls Legal Issues Prevention Diet/ Nutrition Access to Equipment Mental Health Financial Issues Money Management Housing Managing Chronic Conditions In Home Support Services Significant Outcomes (N= 1078 individuals) Improved self management 10% vs. 16.5% system wide hospital readmissions

10 Program Reach All EBPs 15 programs reaching more than 136,000 adults in 46 states, DC, and Puerto Rico 60,000 Evidence-Based Program Participants 50, ,000 30, ,185 20,000 10, ,000 27,774 28, ,822 PY 1 (8/2006-7/2007) PY 2 (8/2007-7/2008) PY 3 (8/2008-7/2009) PY 4 (8/2009-7/2010) PY 5 (8/2010-7/2011) *For CDSMP, MOB, and EF, data available in real-time and is therefore current as of July All other data current as of May 2011.

11 Program Reach CDSMP Only Chronic Disease Self-Management Programs reaching more than 85,000 adults over five years 50,000 45,000 40,000 35,000 30,000 CDSMP Participants i 25,000 20,000 44,591 15,000 10,000 5, ,636 PY 1 (8/2006-7/2007) 9,723 PY 2 (8/2007-7/2008) 12,192 PY 3 (8/2008-7/2009) 16,372 PY 4 (8/2009-7/2010) PY 5 (8/2010-7/2011) Recovery Act CDSMP 54,901 participants (40,957 completers)

12 Implementation Sites 9% Faith-Based Organization Residential Facility 28% Health Care Organization 15% Senior Center Other 24% 24%

13 CDSMP Participant Characteristics Characteristic Percent of Total Age % Gender Female 78% Living Alone 47% Racial/Ethnic Minority Group 33% Multiple Chronic Conditions 59%

14 Chronic Conditions % %

15 ACA Opportunities for EBPs Community-based self-management language is embedded in program description/rfp requirements for: Medical Homes Care Transitions Health Homes Options Counseling Money Follows the Person Veteran s HCBS Directed Services

16 Role of CDSMP in Maryland s Rebalancing Efforts CDSMP is to be offered to all ADRC clients through all long term services and supports programs It will be part of the Options Counseling Standards d being developed which are to be applied in all long term services and supports programs Money Follows the Person Community Living and Veteran Directed HCBS Program Person Centered Hospital Discharge Evidence Based Care Transitions Information and Assistance through ADRCs partners All options counselors from the ADRC partnerships will be trained in Maryland s Options Counseling standards CDSMP will be open to adults 18 and older

17 Partnering with Medicaid Medicaid populations that would benefit from enrollment in the program (including aged, blind, disabled, and/or multiple chronic conditions). Assist the Medicaid office identify criteria for referral (risk factors). Work directly with managed healthcare organizations that provide Medicaid services. Encourage the inclusion of CDSMP as a covered service in fee for service HCBS waivers or managed care Develop cost calculations to include in Medicaid services

18 Partnering with Medicare Develop cost and savings calculations to create a covered Medicare benefit in fee for service or managed care Medicare payor systems Work with AoA and CMS to include as a covered benefit Work with physicians groups to demonstrate the cost savings and quality of life benefits of referring to ADRCs for this service Include CDSMP in the support plans of hospital liaisons in transition programs and in community based programs like Guided Care

19 Other Funding Opportunities Older Americans Act Title III-D Title III-E CDC (Arthritis, Cardiovascular, Diabetes, Health Disparities) HRSA (FQHCs) Medicaid Waivers, State Plan, and ACA initiatives Senior Community Service Employment Program (SCSEP) Employee Wellness Programs

20 NJ Criteria: Funding EBPs with Title IIID Administrative Guidelines Prevention / Health Promotion Services (PM , III - 4 dated April 17, 2009)

21 Program is identified by a leading national authority on healthy aging (Ex: AoA, NCOA, CDC, AHRQ) or NJDHSS as an evidence-based d HP program. Program Authority

22 Intervention is based upon rigorously conducted research with results published in a peer-reviewed journal. Trial must have been conducted on older adults Brief description of program and target population Name of research and study Brief description of study and outcomes Core program elements included in research study and replicated in local program

23 Intervention developed and evaluated for older adults and proven to have positive health outcomes as judged by a consensus of informed experts. Name of Developer/Evaluator Brief description of core components and evaluation outcomes Experts that endorse intervention

24 Program is based on a clinically-evaluated intervention for older adults and community-based implementation can be substantiated. Identify clinically-evaluated intervention, describing intervention and documented outcomes Identify the core components of the clinical intervention provided through the funded service.

25 Questions?