It’s no secret we have an aging population. According to Michigan’s own demographic data, those between 55 and 65 are the fastest growing segment of Michigan’s population.
One of the unanswered questions is how will the complex care for these patients be managed? As increasing numbers of older people need more care, an equally increasing share of the health care workforce will be joining them in retirement.
The Center for Healthcare Research and Transformation (CHRT) published some key research findings regarding evidence-based solutions to this care management challenge.
One model of care the authors identify involve advanced practice nurses following up with high-risk post-discharge patients through one home visit and three phones calls. This led to a 20% reduction in patient costs and a 30% decline in re-admissions.
A second nurse-led model of care is more intensive, relying on regular home visits and care coordination with primary care physicians and specialists by APRNs, which one study found to reduce costs by nearly $5,000 per patient per year.
Furthermore, the authors point to the Program of All-Inclusive Care for the Elderly (PACE) model of care, which uses interprofessional teams to deliver full service care to frail and disabled older adults. These programs face some stringent federal requirements and all patients must use PACE health care providers.
However, these programs have dramatically improved the quality of life for many high-risk patients and have seen a significant reduction in cost and hospitalizations.
These innovative models will need to be more fully explored and expanded to meet what will be a growing need for health care services for the elderly in the future.
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