When mental health providers and hospitals partner with local agencies focused on helping older adults stay independent, Medicare spending decreases and nursing home use falls, according to a new study in Health Affairs.
The study is the first of its kind to evaluate the impact of provider partnerships with Area Agencies on Aging, which are longstanding publicly or privately operated centers located in counties across the country that offer services to help older adults remain independent such as providing meals, in-home support and transportation. The agencies are partially funded by the federal government.
The study found when an Area Agency on Aging established a partnership with a hospital, the counties covered by the agency saw an average yearly reduction in Medicare spending per beneficiary of $135.50. Furthermore, when an Area Agency on Aging created a formal contractual partnership with a local mental health provider, nursing home use for patients with minimal assistance needs decreased by 0.5 percentage points.
"We wanted to highlight the role that Area Agencies on Aging play in their communities and illustrate that these are organizations to partner with," said Amanda Brewster, lead author of the study and assistant professor of health policy and management at the University of California Berkeley. "They are diverse, but they have the benefit of being a pre-existing network."
Area Agencies on Aging were first established in the 1970s, so they have a long history of creating relationships with older adults and community organizations. Brewster said the agencies are perhaps best known for supporting Meals on Wheels efforts in their counties.
Partnerships between healthcare organizations and Area Agencies on Aging have increased in recent years as the industry looks for ways to address social determinants of health, Brewster said.
An example of how Area Agencies on Aging can partner with healthcare organizations is meeting one-on-one with older adults in their home to understand what their needs are and provide recommendations to the partnering organizations about what they can do.
The study used survey data from the National Association of Area Agencies on Aging, which represents the network of 622 of Area Agencies on Aging. For the nursing home use metric, low-care status was used, which indicates potentially unnecessary nursing home use because the patient doesn't need assistance with activities of daily living like eating and using the restroom.
The study also found that partnerships between Area Agencies on Aging and livable community initiatives only led to reductions in low-care nursing home use if the agency received funding to participate. Livable community initiatives describe efforts that brings together multiple stakeholders in a community. If an Area Agency on Aging doesn't have funding or dedicated staff to work on the initiative, nursing home use isn't impacted.
"It takes a level of collaboration and maturity to make a difference," Brewster said of the findings.