Hartford Foundation Trustees Approve Three Grants Totaling $1.8 Million
The John A. Hartford Foundation Board of Trustees has approved three grants totaling $1.8 million that seek to identify potential policy improvements targeting older adults with complex and costly care needs; widely disseminate research, analysis and commentary on innovative health care models; and develop a new model of primary care for testing and evaluation that supports a patient-centered approach to the care of older adults with complex, chronic conditions. Each of the grants supports the Foundation’s new “downstream” strategy for grantmaking focused on putting geriatrics research and knowledge into practice to change health care delivery for older adults.
The John A. Hartford Foundation Board of Trustees has approved three grants totaling $1.8 million that seek to identify potential policy improvements targeting older adults with complex and costly care needs; widely disseminate research, analysis and commentary on innovative health care models; and develop a new model of primary care for testing and evaluation that supports a patient-centered approach to the care of older adults with complex, chronic conditions.
Each of the grants supports the Foundation’s new “downstream” strategy for grantmaking focused on putting geriatrics research and knowledge into practice to change health care delivery for older adults.
In an effort to help policy makers, health systems, philanthropy, and others better understand where to target and how to improve the quality of care for high-need older adults, the board approved $879,465 over two years to the Dartmouth Institute for Health Care Policy and Clinical Practice. The grant, under the new Policy and Communications portfolio, will equip long-time Hartford grantee and geriatrician Julie Bynum, MD, MPH, health care economist Ellen Meara, PhD, and Dartmouth’s extensive research and outreach infrastructure to analyze national Medicare, Medicaid, and nursing home data and examine care patterns and outcomes. The research will paint a more complete picture of older adults with complex care needs—many of whom are so-called “dual-eligible” Medicare and Medicaid beneficiaries—as well as the providers who care for them, the systems in which they receive care, and how this all relates to utilization and costs across Medicare and Medicaid. The findings will be disseminated through academic papers, a geographically specific Dartmouth Atlas report, presentations, and media outreach to increase attention on the potential gaps and opportunities for improvement in primary care delivery and the coordination of acute and long-term care for older adults with complex chronic conditions.
In another move to guide decision-making by health systems leaders and government policy makers, the board approved a $429,481 two-year grant to partner with Health Affairs, the country’s leading health policy journal, to publish and widely disseminate research, analysis, and commentary on new health care models that improve health for older adults. Under the Policy and Communications portfolio, the grant will both advance best practices in geriatric care and position aging and health policy issues as central to the national health care dialogue. Over the two years of the grant, Health Affairs will publish at least 12 peer-reviewed papers that present important policy content and selected authors will take part in at least two Capitol-area briefings. The Hartford Foundation and its grantees will participate in the planning process to identify potential topics and authors for consideration as peer-reviewed Health Affairs papers, and the journal will work with the Foundation’s communications consultants at SCP on extensive media outreach.
Under the new Developing and Disseminating Models of Care portfolio, the board approved a $497,734 planning grant over 18 months to Yale University, with another $400,000 in related funding from other stakeholders, to develop a feasible, sustainable, model of primary care that supports a patient-centered approach to the care of older adults with complex chronic conditions. The model will then potentially be evaluated in a second phase of the initiative. Older adults, on average, see seven physicians (two primary care physicians and five specialists) a year in four different practices, often without true coordination of care. Aligning primary care and specialty care around a patient’s own health goals represents a significant opportunity to improve outcomes for chronically ill older adults. The effort will be led by Mary Tinetti, MD, director of the Hartford Center of Excellence in Geriatric Medicine at Yale, and co-led by Caroline Blaum, MD, chief of geriatrics at New York University. The initiative will build stakeholder engagement and demand for the effort by bringing together providers, payers, patients, and families to identify problems that influence quality, health outcomes, and health care costs for complex older adults and then determine the approach and corresponding evaluation plan aimed at improving care through primary/specialty and patient-centered care redesign.