Category Archives: Health Policy

The John A. Hartford Aging Society Index:
Checking In with Jack Rowe, MD

globe_shutterstock_96211094_300pImagine a tool that could help nations develop smarter policies to address the challenges and opportunities presented by our rapidly aging population.

That is the goal of The John A. Hartford Aging Society Index, currently being developed by the Aging Society Network under the leadership of John W. Rowe, MD.

The Aging Society Index project, approved by The John A. Hartford Foundation’s Board of Trustees in 2015, is working to develop an evidence-based composite measure, or ‘index,’ that describes the capacity of countries to successfully adapt to the world’s aging population.

Continue reading

Putting Our Money Where Our Mouth Is on Oral Health Care for Older Adults

A packed house turned out for the Santa Fe Group convening on oral health care for older adults.

A packed house turned out for the Santa Fe Group convening on oral health care for older adults. Photo courtesy of the Santa Fe Group.

The maxim “Put your money where your mouth is” speaks to doing what you say. For The John A. Hartford Foundation last week, it also took on a more literal meaning, as the Foundation funded an important convening to explore the best ways to enhance access to oral health care for older adults.

The Foundation-supported convening was organized by the Santa Fe Group, a unique collection of internationally renowned scholars and leaders from business and the professions bound by a common interest to improve oral health. The convening brought together an interdisciplinary set of thought leaders to discuss the inclusion of an oral health benefit as part of the Medicare program.

Continue reading

Charting Vital Directions in Health Care for the Next Administration

vd-mc-logo-final-300x300This year’s tumultuous campaign season has been riveting. However, Election Day will soon come and go, and our attention will turn from debates and proposals to the actual policy actions of our newly elected executive and legislative leaders.

Health care, which will likely soon approach nearly 20 percent of gross domestic product, will undoubtedly be among the top policy concerns for our new administration and Congress. The critical question will be how our leaders understand this complex topic and prioritize the directions our country should take. The question is relevant for all of us—health systems leaders, clinicians, advocates, consumers, and philanthropy.

Will we, for example, acknowledge and prepare for the 10,000 baby boomers who turn 65 every day and who are living longer than ever before? (A tremendous success story for humanity, by the way.) Will we focus attention in the right way on the 5 percent of people whose care accounts for 50 percent of costs because of their complex health and social needs?

Continue reading

National Strategy Needed to Support Invisible Heroes of Health Care—Family Caregivers of Older Adults

Click image to view or download a PDF of the full report.

Click image to view or download a PDF of the full report.

For far too long, the nearly 18 million family caregivers of older adults in the United States have been largely invisible to policymakers and our health care system, despite filling an absolutely essential role. The contributions these modern-day heroes make to the care of older adults is indispensable, and often comes at a significant cost to their own health, well-being, and financial security.

Families Caring for an Aging America, the sweeping new report from the blue-ribbon committee convened by the prestigious National Academies of Sciences, Engineering, and Medicine, offers a clear, comprehensive, and compelling rationale for creating a national strategy to elevate the position of family caregivers within our health care system.

Continue reading

Remembering the Needs of Older Adults in the Opioid Debate:
A Conversation with Terry Fulmer and Cary Reid

opioids_shutterstock_343682381_400pAmerica’s opioid epidemic has reached crisis proportions, enough so that last week the United States Surgeon General took the unprecedented step of sending a letter  to 2.3 million American health care professionals asking them to take a pledge to “turn the tide” on the opioid crisis.

Relieving pain is an essential element of good care, and we are appropriately reminded that the use of these powerful medications requires precision, caution, and perspective.

But something very important is missing from this prescription: a recognition of the needs and health challenges of older adults.

Continue reading

Quality Care for People with Serious Illness is about Responsibility and Dignity

JAHF President Terry Fulmer, right, with Tom Koutsoumpas, co-founder of the Coalition to Transform Advanced Care (C-TAC) and President and CEO of the National Partnership for Hospice Innovation (NPHI), at the Roundtable meeting.

JAHF President Terry Fulmer, right, with Tom Koutsoumpas, co-founder of the Coalition to Transform Advanced Care (C-TAC) and President and CEO of the National Partnership for Hospice Innovation (NPHI), at the Roundtable meeting.

John A. Hartford Foundation President Terry Fulmer and I recently participated in the inaugural meeting of the Roundtable on Quality Care for People with Serious Illness, which was held at the National Academies of Sciences Engineering and Medicine (formerly known as the Institute of Medicine).

As I listened to the impressive group of highly knowledgeable and dedicated health care professionals, patients, and caregivers discuss this important topic, I found myself thinking about my mother. She is obsessed with end-of-life planning. Maybe obsessed is too strong a word, but she does talk about it a lot, and she feels strongly about her preferences in the face of serious illness or critical care.

Continue reading

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.

Continue reading

Using Big Data to Improve Care for Older Adults


Click on image above to view or download a PDF of the Dartmouth Atlas Project report.

To fulfill our mission of improving the care of older adults, it is critical to know what is working—and what is not—when it comes to health care for the nation’s growing number of older people. That is why The John A. Hartford Foundation supported a new report from the Dartmouth Atlas Project titled Our Parents, Ourselves: Health Care for an Aging Population.

“This report is really about success,” says Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation. “Life expectancy has almost doubled since the 1900s, from 40 years to 80 years today. The number of adults over age 65 also is projected to almost double in the coming decades, from 43.1 million in 2012 to 83.7 million by 2050. This is truly remarkable and something to celebrate. However, we now need to achieve the same level of success in meeting the care needs of this growing aging population.”

Continue reading

Join the Effort to Ensure That Medicare Covers Skilled Nursing Care for Those Who Need It

CMA_logo_400pGlenda Jimmo is a name you should know.

Mrs. Jimmo, who is blind and had her leg amputated due to diabetes, was the lead plaintiff in a lawsuit brought against the Centers for Medicare and Medicaid Services (CMS) in 2011 by the Center for Medicare Advocacy on behalf of beneficiaries and seven national organizations representing people with chronic conditions. Mrs. Jimmo requires a wheelchair and needs weekly home health services for her complex conditions. However, she was denied Medicare coverage for services on the grounds that she was unlikely to improve.

This rule of thumb—that Medicare services for skilled nursing or therapy should be discontinued when a patient “plateaus” or will no longer improve—is wrong.

Continue reading

A Trifecta of Good News for Supporters of Elder Justice

older_Americans_400pFor those of us who have long advocated for a national agenda to prevent, detect, treat and report the mistreatment of older adults, developments over the summer have sparked some measure of hope and optimism.

The cause of elder justice hit the trifecta, with good news coming from all three branches of the federal government. First, the U.S. Supreme Court decision upholding the Affordable Care Act represented a victory for the Elder Justice Act as well. Enacted by Congress as part of the ACA, the Elder Justice Act targets the widespread issue of elder abuse in communities and long-term care facilities.

Then, at last month’s White House Conference on Aging, President Obama announced that a new rule to be issued by the end of 2015 will clarify that, among other approved uses, assistance funds from the Victims of Crime Act may be used to aid elder victims of abuse, financial exploitation, fraud, and neglect.

Continue reading