Health AGEnda

Five Foundations Join Forces to Improve Care for Chronically Ill Older Adults with Complex Care Needs

5F Social Share V2_400pThe John A. Hartford Foundation has joined with four other outstanding foundations, all dedicated to transforming health care, to form an exciting new collaborative effort that will accelerate changes in our health care delivery system to improve care for high-need, high-cost patients with complex conditions.

This is both a moral imperative and our best opportunity to achieve a more financially sustainable health care system.

We all know someone—an aging mother or father, grandparent, brother or sister, dear friend or neighbor—who struggles with managing several chronic medical conditions. It could be a combination of diseases including diabetes, heart disease, cancer, or dementia, just to name a few. Many of these individuals also have limited ability to care for themselves independently or they might face complex social needs such as poor access to healthy food or housing.

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Triple Aim Approach Is Key to Managing Health Care Costs

doctor_patient_shutterstock_126648713_400pLast week, new projections from the Centers for Medicare and Medicaid Services (CMS) published in Health Affairs show a predicted growth in U.S. health care spending of about 6 percent from 2015-25, outpacing the growth in gross domestic product. In a decade, health care is predicted to represent 20 percent of the U.S. economy. This unsustainable scenario underscores how imperative it is to continue focusing on all aspects of the Triple Aim: improving care, achieving better health outcomes, and managing costs.

These aims perfectly align with our mission and work at The John A. Hartford Foundation, where we remain committed to cost-effective, person-centered innovations that meet the needs of older people and their families.

CMS predicts that much of the projected increase will occur in Medicare and Medicaid expenditures due to the aging of the population. As the Health Affairs report states, there are many complex factors that influence health care spending growth. For example, with the Affordable Care Act, more people are now covered by health insurance than at any time in our nation’s history, and the number of Americans without health insurance is projected to drop to 8 percent by 2025.

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Foundations Partner to Expand Depression Care in Rural Montana

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During the years when copper was king in Butte, Montana, it was known as “The Richest Hill on Earth.”

Editor’s Note: For more than a year, the Health AGEnda blog has been featuring occasional guest posts regarding the eight primary care community clinics receiving funding through the federal Social Innovation Fund (SIF) initiative to spread the IMPACT program, also known as Collaborative Care, in the rural Pacific Northwest.

Today’s guest post by Shelley Stingley shares the story of why The Leona M. and Harry B. Helmsley Charitable Trust decided to partner with The John A. Hartford Foundation and SIF to bring the Collaborative Care model to Bighorn Valley Health Clinic in Hardin, Montana, and Southwest Montana Community Health Center in Butte, Montana.

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States Enacting CARE Act Provide Needed Support
to Caregivers and Their Loved Ones

Caregiving_Walk_400pWhen it comes to improving the care of older adults, family caregivers are too often left out of the equation. This occurs despite their critical role in supporting the health and well-being of millions of older people.

The CARE Act, model legislation developed and spread by AARP and its state offices, has been enacted in about 30 states, providing a new tool to help balance that equation by requiring the identification, notification, and education of family caregivers of individuals who are hospitalized. (For more information, read the AARP Thinking Policy blog post Stepping Up to Support Caregivers.)

While this is just one step in one setting, we have the chance to help implement this law in the right way and leverage it into broader changes so that family caregivers are recognized and assisted in all parts of the health care system.

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Amy Berman Tells Senate Committee:
‘Palliative Care Is the Best Friend of the Seriously Ill’

Amy Berman testifies before the Senate Special Committee on Aging.

Amy Berman testifies before the Senate Special Committee on Aging.

When I was first diagnosed with end stage cancer, I wanted to find a way to use my experience of care to inform people, families, health care providers, and policymakers about the attributes of good care for the seriously ill.

So it was a great honor to be asked to testify before the U.S. Senate Special Committee on Aging in Washington, DC along with Dr. Atul Gawande of Being Mortal fame and Dr. Kate Lally, an extraordinary palliative care physician. The John A. Hartford Foundation is proud to support both of their organizations’ work to improve the lives of older adults.

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A Catalyst for Change: Advancing Better Care for Older Adults – The John A. Hartford Foundation 2015 Annual Report

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Sophie Shepherd at the KANA Clinic in Alaska with therapist Meara Baldwin, LCSW, a care manager in the depression treatment program funded through the SIF initiative. – From the JAHF 2015 Annual Report

The John A. Hartford Foundation is pleased to present its 2015 Annual Report, “A Catalyst for Change: Advancing Better Care for Older Adults.” The report notes the Foundation’s important leadership transitions in 2015 with an introduction by new Board Chair Peggy Wolff and President Terry Fulmer, PhD, RN, FAAN.

In addition to highlighting several important grant projects approved in 2015, the report features an in-depth look at the Foundation’s Social Innovation Fund initiative, a creative public-private partnership that is spreading the evidence-based collaborative care model of depression treatment to underserved, low-income rural communities in Washington, Wyoming, Montana, and Alaska.

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In Pursuit of Elder Justice: Thoughts on World Elder Abuse Awareness Day

WEAAD-Logo-400Today, June 15th, is World Elder Abuse Awareness Day, offering an opportunity for all of us to join a global chorus calling for more awareness and action to end all forms of elder mistreatment.

As a clinician with expertise in caring for older adults, I have made elder mistreatment a priority in my research and practice. It is a common and even deadly problem, but it all too frequently goes undiagnosed and unreported. It has also too often been ignored as the true public health concern that it is.

An estimated one in ten older Americans suffer elder mistreatment, defined as physical, psychological, or sexual abuse, neglect, financial exploitation, or abandonment. I’ve seen it in clinical practice; we sometimes see it in the news. It is horrifying and awful, yet there is much we can immediately do to protect older adults, support their family caregivers, and prevent abuse and mistreatment from occurring.

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New Grants Totaling $4.8 Million Will Bridge Gaps in Care of Older Adults

home_care_shutterstock_428797675_400pWe are very pleased to announce five new grants totaling $4.8 million approved by The John A. Hartford Foundation Board of Trustees in June that target critical gaps that exist in providing comprehensive, age-specific, coordinated care to older adults and their families.

Each of these exciting projects supports the work of innovative organizations and individuals, and all relate to emerging priorities that we see as critical over the next several years.

Through a new initiative that brings together national leaders in the move to improve home-based primary care, we are bridging the gap in care for the frailest, sickest homebound elders for whom house calls could be a saving grace. We are also addressing important gaps in health care policy related to palliative care, hospital admission status, and oral health through outreach, education, and advocacy. And through a potentially game-changing partnership with Kaiser Health News (KHN), we are addressing the gap in high-quality news coverage and public understanding about the complex issues of health care delivery and its impact on older adults and their families.

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Passion and Diversity Create Climate for Innovation to Thrive

JAHF President Terry Fulmer, left, served as a mentor and example of the connection between passion and innovation for Kathrin Lozah during her six-month internship.

JAHF President Terry Fulmer, left, showed Kathrin Lozah the connection between passion and innovation during Lozah’s six-month internship.

Working in a setting that has a diverse group of people with differing backgrounds, education, and experiences who are passionate about what they do creates the ideal habitat for innovation. That is something I learned very quickly in my time working as an intern at The John A. Hartford Foundation over the past six months.

The variety in the skill set of the JAHF staff creates the perfect environment for developing multidisciplinary teams, fostering partnerships, and improving overall creative potential. Degrees and education among the staff members vary significantly, ranging from RNs to MPAs, PhDs to MPHs, and many more.

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Tools You Can Use: Conversation Starter Kit for Alzheimer’s Disease and Other Forms of Dementia

Ellen Goodman_300pEditor’s Note: Today, we welcome Pulitzer Prize-winning writer Ellen Goodman, co-founder and director of The Conversation Project, to Health AGEnda. The Conversation Project is part of a $3.5 million John A. Hartford Foundation grant approved in March supporting an exciting collaborative of six practitioners who will work cooperatively to expand the availability and improve the quality of advance care planning and end-of-life care. Since it was launched in 2010, The Conversation Project has focused on helping families and friends talk openly about their wishes for end-of-life care in a way that makes sure those wishes are not only expressed, but respected.

When we launched The Conversation Project, we knew the importance of encouraging people to express their wishes for end-of-life care before there was a crisis. In a survey we did, people often gave the same excuse for not having the conversation: “it’s too soon.” To which we always replied, “It’s always too soon, until it’s too late.”

There is nothing that shows the wisdom of that statement more than the terrible experiences of families and friends whose loved ones suffer from Alzheimer’s and other dementias.  We—and my family is part of that “we”—often feel tragically unable to have these important conversations after someone we love goes into cognitive decline.

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