We 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.
These projects are part of the Foundation’s continuing efforts to develop and spread innovative models of care that create age-friendly health systems and hospitals, improve serious illness and end-of-life care, and support the absolutely essential role of family caregivers in achieving better outcomes for older adults. These areas will represent key programmatic priorities for the Foundation as we move forward in our work.
We look forward to sharing more over the next several months about these priority areas, as well as information on the new grants authorized this quarter that will bring us closer to meeting the needs of our older adult loved ones and all of our families and communities.
These projects are part of the Foundation’s continuing efforts to develop and spread innovative models of care that create age-friendly health systems and hospitals, improve serious illness and end-of-life care, and support the absolutely essential role of family caregivers in achieving better outcomes for older adults.
Under the leadership of long-time grantees Bruce Leff and Christine Ritchie and in partnership with the Home Centered Care Institute and the American Academy of Home Care Medicine, a three-year, $1.5 million, three-part grant will improve the health of the most frail and vulnerable elders living in the community by increasing access to and the quality of home-based primary care. The recent Independence at Home demonstration in Medicare showed the benefits of this model of care—higher quality and savings of about $25 million in one year. To help spread this success, our initiative’s three components include: a data registry that will be developed to better measure the quality of home-based primary care services; training curricula and educational programming that will build the workforce; and the development and dissemination of informational resources about payment models that support this person-centered model. Together, these three coordinated components will foster more and better trained home-based primary care teams delivering measurably improved care.
In order to improve the care of older adults living with serious illness and at end of life, JAHF will support the esteemed Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) to hold a Roundtable on Quality Care for People with Advanced Illness. In this $211,415 three-year project, we will promote and accelerate implementation of recommendations from the 2014 Institute of Medicine (IOM) report, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The Roundtable process convenes providers, researchers, policymakers, and other key stakeholders who will meet nine times over a three-year period to advance actions and policy work in areas such as access to palliative care and advance care planning.
A two-year $500,000 grant will support the passionately driven and highly expert Center for Medicare Advocacy (CMA), which will raise visibility and diminish the negative impact of the “observation status” classification of older hospitalized adults through outreach and education. Observation status is a categorization of Medicare patients who are deemed to be outpatients rather than admitted inpatients in hospitals, even if their stay extends to multiple days with the same level of care. This status has profound consequences on the quality and cost of care that patients receive. Medicare coverage of often-needed post-acute care in a skilled nursing facility, for example, requires three inpatient hospital days. Over two years, CMA, led by the indomitable Judith Stein, will gather existing resources and collect stories from beneficiaries, produce and update advocacy materials, and conduct extensive outreach and education that will improve observation status policy through regulatory change, improved federal guidance, and increased awareness by legislators. The grant funding for this project will also strengthen CMA’s advocacy on other important issues, including increasing access to oral health care for older adults.
Our health care systems’ ability to provide good oral health care to older adults is also the focus of an 18-month, $100,170 grant to the Santa Fe Group, a unique collective of internationally renowned scholars, business leaders, and health care professionals all dedicated to improving oral health. Older adults often have chronic diseases that may exacerbate oral health conditions, and vice versa. However, Medicare does not cover dental care except in very rare circumstances. More than 70 percent of the Medicare-aged population has no dental insurance, leading to impairments in both their oral and overall health. This grant will activate an interprofessional mix of individuals, institutions, agencies, and organizations who will work collaboratively to identify and execute a multi-pronged strategy to expand dental coverage for older adults. The collaboration will catalyze broad opportunities to define the need and the appropriate set of benefits, focusing on expanding dental coverage under Medicare Part B and within Medicare Advantage programs.
We are also very excited to partner with Kaiser Health News, the nation’s leading health policy news service. A three-year, $2.4 million grant will establish a top-tier reporting desk that will significantly build awareness and understanding of geriatric care issues among the public, policymakers, and the health care sector in order to more rapidly influence practice and policy change. KHN will focus on both problems and solutions in how health care systems work, the policies that drive their behavior, and the care experiences of older people and their families. The project will produce hundreds of in-depth articles, several large-scale investigative projects and public events, and consumer-friendly informational resources that will help drive the public to demand better care for older people and their families. KHN has distribution partnerships with The Washington Post, NPR, and many other media outlets that reach tens of millions of people. The project will benefit from the overall reporting resources of KHN and the highly regarded polling and research capacities of its parent organization, the Kaiser Family Foundation.
JAHF is proud to support and collaborate with these outstanding organizations and their leaders and staff to advance better care for older adults in very important, specific areas. And we continue to look for opportunities to accelerate the changes in health care delivery that all older adults and their families deserve.
For more information, see Five New Grants Totaling $4.8 Million Approved by JAHF Board of Trustees at June 2016 Meeting.