Care Coordination Improves Outcomes and Reduces Cost

Abstract

Background: Older adults want to live independently at home and postpone or avoid nursing home placement Long term care expenses are expected to more than double between 2000 and 2040. To address these concerns, a new model of care using registered nurse (RN) care coordination coupled with in-home services was developed based on prior research helping older adults age in place. Built and operated by Americare, a leading long-term care provider, TigerPlace, an independent senior living facility, was designed as a demonstration site for the aging in place model. The Sinclair School of Nursing developed a home health agency to provide RN care coordination and home care services to TigerPlace and the surrounding community. Personal care, skilled nursing and hospice services are arranged to assist residents and health promotion activities are provided to maintain independence enabling aging in place.Purpose: Assess the impact of the aging in place model of care on costs and outcomes.Methodology: A semi-annual comprehensive health assessment including the mini-mental state exam, geriatric depression scale, minimum data set, fall risk assessment and SF-12 health survey was completed on all of the residents of TigerPlace (n=66) from 2005 to 2008. Adverse events and costs of services provided were also tracked. Statistical summaries were prepared about the clinical and cost data.Findings: RN care coordination reduces adverse health events, improves outcomes, reduces nursing home utilization and is cost effective. The cost for any resident (both care and housing) has never approached or exceeded the cost of nursing home care (average annual cost for care in 2008 was $3,594 plus housing costs).Summary Concluding Statement: RN care coordination coupled with in-home services can be a viable option for long term care while saving money and allowing older adults to remain independent in a pleasing, private apartment, congregate housing setting. Background: Older adults want to live independently at home and postpone or avoid nursing home placement Long term care expenses are expected to more than double between 2000 and 2040. To address these concerns, a new model of care using registered nurse (RN) care coordination coupled with in-home services was developed based on prior research helping older adults age in place. Built and operated by Americare, a leading long-term care provider, TigerPlace, an independent senior living facility, was designed as a demonstration site for the aging in place model. The Sinclair School of Nursing developed a home health agency to provide RN care coordination and home care services to TigerPlace and the surrounding community. Personal care, skilled nursing and hospice services are arranged to assist residents and health promotion activities are provided to maintain independence enabling aging in place. Purpose: Assess the impact of the aging in place model of care on costs and outcomes. Methodology: A semi-annual comprehensive health assessment including the mini-mental state exam, geriatric depression scale, minimum data set, fall risk assessment and SF-12 health survey was completed on all of the residents of TigerPlace (n=66) from 2005 to 2008. Adverse events and costs of services provided were also tracked. Statistical summaries were prepared about the clinical and cost data. Findings: RN care coordination reduces adverse health events, improves outcomes, reduces nursing home utilization and is cost effective. The cost for any resident (both care and housing) has never approached or exceeded the cost of nursing home care (average annual cost for care in 2008 was $3,594 plus housing costs). Summary Concluding Statement: RN care coordination coupled with in-home services can be a viable option for long term care while saving money and allowing older adults to remain independent in a pleasing, private apartment, congregate housing setting.