Sunday, September 03, 2017 1:00 am
Smarter strategies for care of the aging
Overwhelmingly, older people want to be able to stay in their own homes, and the efforts aging agencies and other social agencies provide are clearly helping them do that.
According to Northeast Indiana Aging and In-Home Services board President Keith Huffman, “2013 was the first time across the United States more money was spent on the aged and disabled at home instead of in institutions. In the state of Indiana, we're still at about 58 percent institutions, 42 percent at home.”
But, Huffman said, Indiana is committed to reaching a 50-50 home/institution split by 2020, and the state's long-term-care landscape is already changing.
“There are the same number of people in nursing homes as there were 10 years ago, almost within 100 people,” Huffman said. “Despite the fact that the population is aging, there are a lot of other options available to seniors now. We have a lot more assisted living facilities. We have a lot more (Medicaid) waiver services, so that people are getting services at home or in assisted living instead of in a nursing home. There's a moratorium on building new nursing homes right now because there isn't a need right now. Those needs are being met in other places.”
Case management by her agency “is (about) $700-to-$1,000 a month to support an individual in their own home,” said Connie Benton Wolfe, Aging and In-Home President and CEO. The average cost for nursing home care in Indiana is $6,439 a month.
“The cost savings are pretty dramatic,” she said.
One of the strategies Benton Wolfe's agency has formed in pursuit of integrated care is a partnership with Parkview Health to develop an electronic medical records system that allows her to share her agency's assessments with insurers, medical caregivers and nursing homes.
Since 2013, her agency has operated a federally funded pilot program aimed at reducing hospital readmissions for high-risk Medicare patients.
Working in 10 hospitals in 38 counties, Aging and In-Home staff picked up where traditional medical care left off – as patients prepared to leave for home.
“We'd meet them in the hospital,” Benton Wolfe said. “Within 48 hours we'd be in their home. We made sure they understood their discharge instructions. We made sure they understood their prescriptions and that they could get the prescriptions they needed. We made sure they made their follow-up visits with primary-care docs and provided transportation for those who needed it. We made sure they had food in the house.
“We helped them become advocates for their own health care and understand red flags for what might put them back into the hospital.”
The result? In four years, working with more than 13,000 patients, the pilot program reduced hospital admissions by 43 percent, and saved more than $5 million.