Hospitals to share more risk with skilled nursing, other partners in pilot for elderly care

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A new pilot being tested by the American Hospital Association in five U.S. health systems aims to create “age-friendly” care that focuses on safety, patient satisfaction and universal value.

The AHA describes its system-oriented approach In a nine-page document outlining its efforts. The effort is supported by the Institute for Healthcare Improvement, the Catholic Health Association and the John A. Hartford Foundation.

Goals include individual health outcome goals; using age-friendly medications; identifying and managing depression, dementia and delirium; and ensuring  older adults move safely to maintain function and “do what matters.”

“This new environment of care, in which health systems assume more risk and potentially share in cost savings, will spur those systems to develop better coordination and integration of care across the continuum,” AHA said. “Managing the health systems' resources to be more cost effective is particularly critical in the care for older adults, as one in every five Medicare beneficiaries is hospitalized one or more times each year.”

The prototype is being tested in hospitals, long-term care, ambulatory and post-acute settings. Among the specific initiatives that would impact skilled nursing providers are scheduling “pharmacovigilance” meetings among care providers; redesigning medication reconciliation; reaching out to inpatient providers to help ensure delirium notification and results are communicated and understood; and studying the impact of dementia on illness presentation.

The test sites include Anne Arundel Medical Center, based just outside of Baltimore; Ascension, Kaiser Permanente, Providence St. Joseph Health and Trinity Health.

Kaiser Permanente's Woodland Hills Medical Center in California is working to reach nearly 3,500 older adults in its acute elderly care units, nursing and rehab center and a palliative care clinic. The company has already developed patient-friendly medication lists, and is working with its rehab therapists to develop an exercise list that could help residents meet their goals.