Tag Archive for: PACE Expansion

How PACE offers a roadmap to achieve the Triple Aim

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This article was originally published on Medical Economics.

It’s never once crossed my mind that I’d write an authorization to remove bed bugs from a patient’s home. Further, I wouldn’t have thought that treating bed bugs would save money for taxpayers.

That is until I joined the Program of All-Inclusive Care for the Elderly (PACE), a national program that helps seniors age independently in their own homes. PACE programs nationwide understand that our patients, known as “participants,” want to stay at home.

As we deliver these services, we’re guided by the Triple Aim of health care – a framework to improve outcomes and reduce costs, all while boosting patient satisfaction. This benchmark is particularly familiar to those who serve high-need populations, like senior care organizations. What’s less known, however, is that PACE has been delivering on the Triple Aim for over 50 years. Here’s how.

Improving Outcomes

Rather than watch, wait and then simply treat symptoms, as is often the case in the traditional, fee-for-service (FFS) Medicare model, PACE helps address the root cause of a participant’s health issues, reducing the potential for later complications and downstream costs. This can range from monitoring a pre-existing condition to preventive health exams and tests, or even addressing a bed bug infestation that caused severe skin irritation for a participant. Though unconventional, it’s a perfect example of what makes PACE unique.

The secret to this quick intervention is our interdisciplinary team (IDT), a key facet of any PACE program, which includes primary care physicians, nutritionists, physical therapists, home care aides and drivers who coordinate transportation to and from PACE day centers, among others.

Reducing Costs

In a capitated payment system, like that used in PACE, providers receive a fixed payment amount per patient. This model incentivizes providers to prioritize quality and efficiency, aiming to keep patients healthy and minimize costly, unnecessary interventions. PACE’s approach demonstrates how a focus on value-based, patient-centered care can create a sustainable system that improves health outcomes while efficiently managing health care spending.

By addressing the source of health care issues, PACE has generated impressive results. PACE participants are significantly less likely to be hospitalized or use emergency care than Medicare Advantage (MA) enrollees. It’s no surprise then that PACE also provides substantial cost savings to participants and payers. One study found that South Carolina and Wyoming save over $9,000 and $12,000 per year, per PACE participant, respectively, when compared with residents in alternative long-term care settings such as nursing homes.

It’s not only state budgets and taxpayers that benefit; PACE covers the costs of any services it doesn’t offer internally to its participants, such as emergency department visits and hospital stays. And saving on fees, co-pays and deductibles makes an enormous difference for low-income, older Americans.

Boosting Satisfaction

Cost is a necessary topic in any health care discussion, but PACE is so much more than the bottom line. The program is designed to improve participants’ physical, mental, and emotional health, helping seniors – many of whom are in fragile health upon enrollment – transform and thrive.

And let’s not forget family caregivers. PACE services help to relieve the burden on these undervalued caregivers who often are juggling the demands of their own jobs and families while providing care for aging loved ones. It’s no wonder, then, that 95% of family caregivers would recommend PACE.

Expanding PACE

The PACE program is a vital component of the long-term care puzzle. More can and must be done in Congress and in state houses to help older adults access the PACE services that they need when they need them.

The bipartisan PACE Anytime Act (S. 4781), recently introduced in Congress, is a promising start. Currently, older adults are forced to wait until the first day of the month to enroll in a PACE program – a bureaucratic requirement that creates delays and puts chronically ill seniors at risk for falls, hospitalizations, and other acute medical crises. The PACE Anytime Act would allow potential participants to enroll any day of the month, removing an arbitrary obstacle for older individuals who will immediately benefit from PACE services.

Expanding the program is an important step to bring the entire senior care industry closer to achieving lower costs, better outcomes and greater satisfaction. That’s why I urge our lawmakers to act immediately and advance the PACE Anytime Act to make the Triple Aim a reality in our health care system.

 

Element Care on PACE for Grand Opening in Lynn

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This article was originally published on Item Live.

LYNN — Element Care cut the ribbon for its newest Program of All-Inclusive Care for the Elderly (PACE) site, the Magnolia A. Contreras Day Center, on Thursday.

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NPA President and CEO Shawn Bloom Calls for End to Barrier to PACE Access

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This article was originally published on NPA Online.

SAN DIEGO – Oct. 13, 2024 – As the National PACE Association (NPA) kicks off its annual conference this week, president and CEO Shawn Bloom called for the removal of a key barrier that is denying millions of Americans access to Programs of All-Inclusive Care for the Elderly (PACE).

PACE is celebrated for its ability to allow older adults to age in place by providing high-quality home- and community-based care that is coordinated by a team of health care and service providers. The COVID-19 pandemic greatly accelerated the shift toward home- and community-based care as an alternative to skilled nursing facilities. While PACE is experiencing tremendous growth, many people currently cannot afford to enroll in the program because of an unintended penalty on its Part D services.

Unlike other Medicare enrollees, people who participate in PACE are required by federal law to enroll exclusively in the PACE Part D drug benefit. This drug plan costs up to 22 times more on average than the many more affordable Part D plans available to every other person enrolled in Medicare on the open market.

“Congress has a bill under consideration that provides a simple fix with a significant impact,” Bloom said. “The bipartisan PACE Part D Choice Act (S.1703/H.R. 3549) does away with the mandate that PACE program participants with Medicare must enroll in the PACE Part D drug plan and instead allows them to purchase a more affordable Part D plan from the open market.”

Passage of the bill would provide access to a new model of care for millions of seniors and their families, he said.

NPA is convening PACE leaders at its annual conference in San Diego through Oct. 16. NPA will celebrate its 30th anniversary during the event, which will be the most highly attended conference in its history.

About National PACE Association

The National PACE Association (NPA) works to advance the efforts of PACE programs, which coordinate and provide preventive, primary, acute and long-term care services so older individuals can continue living in the community. The PACE model of care is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. For more information, visit www.NPAonline.org.

NPA Applauds PACE Anytime Act Introduced by Sens. Bob Casey and Mike Braun

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This article was originally published on NPA Online.

WASHINGTON, DC – July 25, 2024 – The National PACE Association (NPA) expressed its enthusiastic support of the bipartisan PACE Anytime Act introduced today by U.S. Sens. Bob Casey (D-PA) and Mike Braun (R-IN), chair and ranking member, respectively, of the U.S. Senate Special Committee on Aging. The legislation would allow eligible individuals to enroll in PACE at any time during the month.

NPA applauds the senators for addressing a significant barrier facing older adults wanting to enroll in the Program of All-Inclusive Care for the Elderly (PACE). Currently, new enrollees may begin receiving care only on the first day of every month. The bill also provides the ability to prorate capitation payments to account for varying PACE enrollment dates.

“No older adult should have to wait until the first of the month to begin receiving care and services from PACE,” said Shawn Bloom, president and CEO of NPA. “Given the rapidly rising numbers of older Americans and their clear desire to age in place, it is imperative for our nation to encourage ready access to PACE, which is a holistic model of care that is well equipped to meet individuals’ complex care needs at home and in the community rather than in a nursing facility.”

Other comparable providers, including skilled nursing facilities (SNFs), home health and hospice, are not required to wait for the first of the month to enroll patients who need immediate care. In addition to delaying care, PACE enrollment limitations often force PACE-eligible individuals to seek care in SNFs and other modalities that are critically overburdened.

NPA is grateful to Sens. Casey and Braun for seeking to rectify this inequity so older adults do not face arbitrary delays in obtaining life-sustaining care from PACE, said Bloom.

The National PACE Association (NPA) works to advance the efforts of PACE programs, which coordinate and provide preventive, primary, acute and long-term care services so older individuals can continue living in the community. The PACE model of care is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. For more information, visit www.NPAonline.org and follow @TweetNPA.

Physicians Among Bipartisan Leaders Calling for Expanded Access to PACE

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This article was originally published on NPA Online.

WASHINGTON, DC – June 10, 2024 – The Program of All-Inclusive Care for the Elderly (PACE) is widely seen as a model of care that allows seniors to remain living at home instead of in a nursing facility, with a better quality of life and clinical outcomes. Most PACE participants are eligible for Medicaid. Seniors who are covered only by Medicare are eligible to enroll as well, but few do. Concerned about the barriers to enrollment for Medicare beneficiaries, the National PACE Association (NPA) held a Capitol Hill briefing on June 7 to urge lawmakers to increase access to PACE for older adults whose income levels disqualify them from Medicaid.

Legislators from both sides of the aisle spoke during the briefing, as well as a representative of the Bipartisan Policy Center and a private citizen seeking access to PACE. In attendance were U.S. Sen. Tom Carper (D-DE); U.S. Sen. Bill Cassidy (R-LA), MD; U.S. Rep. Brad Wenstrup (R-OH-2), DPM; and former Kansas Gov. Jeff Colyer (R), MD. Other speakers were Lisa Harootunian, associate director of Health at the Bipartisan Policy Center; and Linda Henderson, for whom PACE Part D costs are a barrier to enrolling in the program.

Currently, more than 76,000 seniors participate in PACE, with 164 programs in 32 states and the District of Columbia. PACE empowers older adults and people with disabilities to live at home and in their communities despite being eligible for nursing home care. All of their health care, nutrition, transportation and other needs are identified and addressed in an individualized care plan by a dedicated interdisciplinary team.

A key barrier to enrolling in PACE for Medicare beneficiaries is the exorbitant Part D premium for prescription drugs. Part D costs are significantly higher for PACE participants than the millions of other Medicare beneficiaries – 22 times higher on average. Two bills now before Congress – the PACE Part D Choice Act and the DUALS Act of 2024 – would eliminate this burden on PACE participants. Both have bipartisan support.

The legislators and other speakers at the recent Capitol Hill briefing expressed their support for both bills.

“Leading the charge to expand access to PACE is a team of bipartisan senior lawmakers and experts – many of whom are also physicians,” said Shawn Bloom, president and CEO of NPA. “PACE is a nonpartisan issue. It is a health care solution. PACE allows seniors to live independently in their homes with all of their health and long-term care needs met. We need the legislation to pass in order to level the playing field for this critical segment of our population.”

 

Element Care PACE Opens New Site to Expand PACE Services to Seniors in Massachusetts

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This article was originally published on Business Wire.

Massachusetts-based non-profit expands PACE program offerings to underserved adults over 55 in Lynn and surrounding areas

LYNN, Mass., June 10, 2024–(BUSINESS WIRE)–Element Care PACE, a non-profit healthcare organization helping older adults live safely and comfortably in their homes, is celebrating the opening of its new PACE site in Lynn, Massachusetts. With 13,000 square feet, the new PACE Center will service as the new administrative headquarters and provide essential, comprehensive medical services and activities to keep adults over 55 healthy and engaged in their community.

“For the last three decades, we’ve taken pride in providing quality care for adults by bringing all medical services under one roof, including interdisciplinary care teams, an emphasized focus on preventive medicine, and a commitment to personalized attention,” said Robert Wakefield, Jr, Chief Executive Officer at Element Care PACE. “The opening of this new PACE site marks the next chapter for Element Care PACE, and the ability to serve more Massachusetts seniors in need.”

Amenities at the new site include a teaching kitchen, library, activities room, sunroom, memory care and exam facilities, gardens, and an enclosed courtyard. The site includes murals in the first floor Woodland Rehab hallway, painted by students in the Raw Art Works youth arts organization. There are also 2Life Communities senior housing apartments being built next door to provide affordable housing solutions for eligible seniors.

The new PACE center opens as a boom is expected in the aging population, with the World Health Organization estimating one in six people in the world will be aged over 60 years or over by 2030. Nationally, Massachusetts is one of two states with the highest number of PACE enrollees.

“As the population of aging seniors continues to grow, it is crucial to provide access to quality, coordinated healthcare,” said Robert Wakefield, Jr. at Element Care PACE. “The aging population in the North Shore communities of Massachusetts will benefit greatly from the expansion of Element Care PACE.”

The Medicare and Medicaid-funded Program of All-Inclusive Care for the Elderly (PACE) provides comprehensive medical services, helps reduce barriers to care and offers a proactive and person-centered approach to senior healthcare, particularly for low-income seniors. PACE unified care teams cover the facilitation of several aspects of medical care including basic well and sick visits, dental, eye, and hearing care, rehabilitation, along with screenings, therapy appointments, and more. Studies show PACE participants have lower rates of hospital stays and readmissions and improved quality of life.

 

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Fallon Health Plans to Expand Inclusive Care Program into Southeastern Massachusetts

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This article was originally published on South Coast Today.

Fallon Health, a not-for-profit healthcare services organization based in Worcester with more than 45 years of experience providing care, has plans to open a new Summit ElderCare PACE Center in Dartmouth by the end of this year.

PACE, a Program of All-Inclusive Care for the Elderly, provides services to adults 55 and older, including adults with complex medical needs, so they can age with dignity in their home or community. It’s the biggest PACE program in Massachusetts.

Kristine Bostek, senior vice president of PACE Programs, said if the service area that would include Bristol and Plymouth counties and part of Barnstable County receives final approval, there may be as many as 9,000 residents eligible for PACE in the area.

“We’re excited about the opportunity to really continue to help the state meet their goal of being statewide for PACE, and that’s something that we’re really excited to be able to continue to do over the next several years,” she said.

The other Massachusetts Fallon PACE locations are in Webster, Lowell, Leominster and Springfield. Fallon also has a PACE in western New York.

It’s called a PACE desert

Bostek said Fallon Health has worked closely with Massachusetts officials who had an interest in expanding services to the Dartmouth area as part of PACE’s expansion across the state.

She said Mass Health officials focused on Dartmouth because there are many people in the area who are eligible for the program and live within the 35-mile radius of the closest Fallon PACE center in Webster.

All PACE programs across the country are regulated by and work with the Centers for Medicare & Medicaid (CMS). The first PACE program in Massachusetts opened 30 years ago in Worcester, and there are now five PACE programs across 10 counties.

While the project is still in the development and implementation phase, Bostek said they are in the process of constructing a new building at 491 Faunce Corner Road.

The Massachusetts Executive Office of Health and Human Services has granted preliminary approval to file an application with CMS seeking authorization to build the PACE facility in Dartmouth, but it can’t open without final approval.

As care provider and insurer

Bostek said PACE is the care provider through its clinical staff and is also the health insurer for its program participants.

“These individuals that are in our program would otherwise live in a nursing home,” she said. “They are complex older adults who have a lot of medical and likely social needs and therefore it’s a huge responsibility for us to take care of them 24 hours a day every day of the year.”

Bostek said they will be reaching out to educate the public about what PACE does for its referral sources and other providers from the community and the people who will benefit from the program and their caregivers.

Fallon Health has a presence in the area with its other services, she said, and PACE wants to build relationships with the hospital systems and providers as well as senior agencies and grassroots organizations to get to know the area better as part of its commitment.

The capacity of the facility

The Dartmouth facility would be Fallon’s largest PACE site. Bostek said it’s anticipated there will be 300 to 350 people enrolled in the PACE program over the course of several years based on experience with their other locations.

She said it’s a very personalized and involved process because it’s a big step to take to enter the program, and most of the people are on Medicaid and Medicare and must meet eligibility requirements and qualify as eligible for a nursing room level of care.

The case model requires 11 different disciplines to everybody that enrolls in a PACE program with an interdisciplinary team consisting of providers including a medical doctor, a nurse, physical therapist, occupational therapist, speech therapist, a social worker, a dietitian, a health aid and a transportation coordinator.

“These people live independently in the community with the services that we provide so we do a lot of that in their homes whether it’s therapy, nursing or meetings with the social worker, the doctor or the nurse practitioner,” she said.

The building will feature clinical space with exam rooms, day rooms for activities, socializing and meals, a rehabilitation gym, separate space for memory care needs, conference rooms for meetings, outdoor space and office space for staff.

They can also receive medical care, get physical therapy or meet with a dietitian at the center.

 

State Offers Initial Support for Expansion of PACE Program to Serve Additional Counties

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This article was originally posted on South Coast Today. Read the full article here.

Fallon Health, a not-for-profit healthcare services organization based in Worcester with more than 45 years of experience providing care, has plans to open a new Summit ElderCare PACE Center in Dartmouth by the end of this year.

PACE, a Program of All-Inclusive Care for the Elderly, provides services to adults 55 and older, including adults with complex medical needs, so they can age with dignity in their home or community. It’s the biggest PACE program in Massachusetts.

Kristine Bostek, senior vice president of PACE Programs, said if the service area that would include Bristol and Plymouth counties and part of Barnstable County receives final approval, there may be as many as 9,000 residents eligible for PACE in the area.

“We’re excited about the opportunity to really continue to help the state meet their goal of being statewide for PACE, and that’s something that we’re really excited to be able to continue to do over the next several years,” she said.

The other Massachusetts Fallon PACE locations are in Webster, Lowell, Leominster and Springfield. Fallon also has a PACE in western New York.

It’s called a PACE desert

Bostek said Fallon Health has worked closely with Massachusetts officials who had an interest in expanding services to the Dartmouth area as part of PACE’s expansion across the state.

She said Mass Health officials focused on Dartmouth because there are many people in the area who are eligible for the program and live within the 35-mile radius of the closest Fallon PACE center in Webster.

All PACE programs across the country are regulated by and work with the Centers for Medicare & Medicaid (CMS). The first PACE program in Massachusetts opened 30 years ago in Worcester, and there are now five PACE programs across 10 counties.

While the project is still in the development and implementation phase, Bostek said they are in the process of constructing a new building at 491 Faunce Corner Road.

The Massachusetts Executive Office of Health and Human Services has granted preliminary approval to file an application with CMS seeking authorization to build the PACE facility in Dartmouth, but it can’t open without final approval.

As care provider and insurer

Bostek said PACE is the care provider through its clinical staff and is also the health insurer for its program participants.

“These individuals that are in our program would otherwise live in a nursing home,” she said. “They are complex older adults who have a lot of medical and likely social needs and therefore it’s a huge responsibility for us to take care of them 24 hours a day every day of the year.”

Bostek said they will be reaching out to educate the public about what PACE does for its referral sources and other providers from the community and the people who will benefit from the program and their caregivers.

Fallon Health has a presence in the area with its other services, she said, and PACE wants to build relationships with the hospital systems and providers as well as senior agencies and grassroots organizations to get to know the area better as part of its commitment.

The capacity of the facility

The Dartmouth facility would be Fallon’s largest PACE site. Bostek said it’s anticipated there will be 300 to 350 people enrolled in the PACE program over the course of several years based on experience with their other locations.

She said it’s a very personalized and involved process because it’s a big step to take to enter the program, and most of the people are on Medicaid and Medicare and must meet eligibility requirements and qualify as eligible for a nursing room level of care.

The case model requires 11 different disciplines to everybody that enrolls in a PACE program with an interdisciplinary team consisting of providers including a medical doctor, a nurse, physical therapist, occupational therapist, speech therapist, a social worker, a dietitian, a health aid and a transportation coordinator.

“These people live independently in the community with the services that we provide so we do a lot of that in their homes whether it’s therapy, nursing or meetings with the social worker, the doctor or the nurse practitioner,” she said.

The building will feature clinical space with exam rooms, day rooms for activities, socializing and meals, a rehabilitation gym, separate space for memory care needs, conference rooms for meetings, outdoor space and office space for staff.

They can also receive medical care, get physical therapy or meet with a dietitian at the center.

PACE gains speed as states seek nursing home alternatives

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This article was originally posted on Modern Healthcare. Read the full article here.

A little-known program to keep low-income seniors out of nursing homes is getting a shot in the arm.

LTSS Choices: From Ideation to Standard Practice: Scaling Innovation in Long-term Services and Supports

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This article was originally posted on AARP. Read the full article here.

Most innovations take a long time to diffuse, or simply may fail to do so. For example, in health care, the average time it takes for an evidence-based practice to make its way into general practice is 17 years, and half of all new practices never become widespread. But five promising innovations that show positive outcomes in the long-term services and supports (LTSS) system are becoming more commonplace. This paper examines these innovative programs, and the diffusion of innovation, or scaling-up process, underlying them.

A widely accepted model for understanding the expansion or diffusion of an innovation was developed in the 1960s by sociologist E.M. Rogers, who coined the phrase “early adopter.” He theorized that innovations are most likely to be adopted if they have the following elements: greater relative advantage; more compatibility with innovators’ values; less complexity; more trialability or testing opportunities; and, greater renown or observability.

After reviewing the history of five promising and expanding innovations in LTSS systems through Rogers’s framework, this report finds that a combination of factors, predicted by the model, leads to their diffusion:

  • Innovators trying to solve problems with their state and local LTSS systems
  • Innovations that are compatible with the ethics and needs of the innovators
  • Local and state level experimentation that demonstrates the cost-effectiveness of the innovations
  • Foundations and government policy makers working together to test and refine the innovations and providing technical assistance to reduce complexity, costs, and risks for potential adopters
  • Successful innovations, in terms of diffusion, that have backers who disseminate information about them
  • Policy makers who alter policy, increase funding, and provide technical assistance to help states and localities expand the innovations
  • Relative advantage and compatibility appear to be the most influential factors affecting the speed at which innovations spread.

A note about scaling and LTSS equity: Research into new and existing models of LTSS should always include diverse populations and resulting publications should be specific about the populations included in a given study or intervention. This transparency is critical to understanding whether and to what extent the innovation is relevant across populations. At the same time, diverse communities should not be treated only as test populations. As innovations come to scale beyond the study phase, they should do so in ways that offer different types of communities access to the services and supports.

Five Promising LTSS Innovations

1) Program of All-Inclusive Care for the Elderly (PACE)

The genesis for PACE was called On Lok, and began in the early 1970s in the Chinatown district of San Francisco, helping older adults of Chinese, Filipino, and Italian heritage live at home while receiving LTSS. It began providing medical services, social rehabilitation, and daily care; over time, it added meals, transport, and at-home services and day-care centers. The heart of the PACE model is person-centered services led by an interdisciplinary team that includes primary care providers, social workers, dietitians, therapists, personal care attendants, and drivers. A combination of Medicare Parts A, B, and D and Medicaid cover the associated costs.

Although today more than 140 PACE sites exist, most are small; they serve, on average, about 470 people.

2) Green House® Nursing Homes

Bill Thomas, a medical director at a nursing home in rural New York State in the early 1990s, noticed that residents lived according to a fixed schedule, had little to do, were lonely, and had no control over their lives. Among the changes he implemented to remedy this were a focus on person-centered care and empowering staff to learn more about residents so they could better meet residents’ individual needs. He also created a more homelike environment by bringing animals into the building, giving residents more choices, and decreasing use of psychotropics. Thomas called his program the Eden Alternative, and hundreds of nursing homes adopted his principles, likely due to his active promotion through presentations and articles. Later, the Robert Wood Johnson Foundation (RWJF) provided a small grant, then a five-year, $10 million grant to fund the Green House Replication Initiative.

The first four Green House nursing homes were built in 2003; there are now 371 trademarked homes on about 70 campuses in 32 states. These homes serve about 3,200 people.

Read the LTSS Choices report on Green House homes for more information including a discussion of their unique staffing model.

3) Self-Directed Home and Community-Based Services (HCBS)

Self-directed HCBS (home and community-based care) programs typically give beneficiaries a monthly allowance they can use to hire their own workers, including family members, and, in many cases, to purchase care-related services and supplies. This type of program originated in the 1960s at the local and state levels and via a federal veterans home care allowance after World War II. One of the first major efforts was California’s independent living model, based on a program operated for college students with disabilities in Berkeley through the first Center for Independent Living. After successful testing of the “Cash and Counseling” program in the late 1990s and early 2000s, Medicaid, at the federal level, recognized two forms of self-direction: beneficiaries can employ workers directly, or they can manage a budget and purchase HCBS.

As of 2019, the National Inventory of Self-Directed Programs reported that self-direction models reached 1,234,214 participants through 267 separate programs, 71 of which were veteran directed. In fiscal year 2018, up to 4.8 million beneficiaries received Medicaid HCBS.

4) Supportive Services in Housing for Older Adults

Supportive services in housing programs for older adults are designed to connect residents with services that can help them remain at home. State and federal involvement began in the late 1980s; some funding from RWJF came in the late 1980s and early 1990s. In 1990, Congress permitted certain federally funded housing projects to hire service coordinators for elderly and disabled residents. In 2009, Cathedral Square, a Vermont nonprofit housing and services provider, piloted the SASH® (Support and Services at Home) model, which has led to important improvements in residents’ health. As a result, supported services in housing are poised for more replication, particularly if a related innovation, IWISH (Integrated Wellness in Supportive Housing) proves effective.

Read the LTSS Choices report on the SASH housing model, its multiple positive outcomes for residents and lower costs.

5) ABLE and CAPABLE

Two innovations, initiated by Johns Hopkins researchers, rely on occupational therapy, physical therapy, and home repair professionals to improve LTSS for older adults and help them remain at home.

The initial program, Advancing Better Living for Elders (ABLE), provided four visits and one telephone contact from an occupational therapist and one visit from a physical therapist during a six-month period. The occupational therapist worked with participants to identify problem areas and helped them to improve function through behavioral and environmental modifications. Physical therapists delivered strengthening and balance exercises to support improvement in targeted areas. In the second six-month period, occupational therapists had three telephone contacts with participants.

Community Aging in Place, Advancing Better Living for Elders (CAPABLE) built on the ABLE model by adding a registered nurse to address pain management, medications, depression, and a handyperson to perform home repairs and install assistive devices and modify the home. Participants work with an occupational therapist and a registered nurse to identify up to three achievable goals with each.

The CAPABLE innovation, when thoroughly implemented, is of real benefit to older adults in terms of function and quality of life as well as emotional well-being. It also shows sustained cost savings. It is poised to expand but needs more attention from the federal government and foundations

Recommendations for Choosing and Promoting LTSS Innovations

Based on this exploration of five promising innovations in various stages of diffusion or scaling up, the report offers five recommendations that tailor Rogers’s five elements to the project of selecting and promoting LTSS innovations. A second set of recommendations specify a role for a) policy makers, b) funders, c) researchers, d) innovators, and e) thought leaders in successfully scaling up LTSS innovations that benefit consumers and reduce costs.

Suggested Citation:
Reinhard, Susan, Jane Tilly, and Brendan Flinn. LTSS Choices: From Ideation to Standard Practice: Scaling Innovations in Long-Term Services and Supports. Washington, DC: AARP Public Policy Institute, November 2022. https://doi.org/10.26419/ppi.00176.001