Healthcare Management Costs & the Aging Population

RON HARRIS: I’m Ron Harris from University of San Francisco, and I have a case study to present called Louisiana Answers for Living at Home. This is a state pilot program for aging in place. The learning objectives for this case study are to know about strategies for aging in place, to learn about cost analysis for evaluation, and to compare program costs with alternatives.

RON HARRIS [continued]: [Louisiana Answers for Living at Home Introduction]

RON HARRIS: More than 79 million people in America have begun to retire, and they’re retiring over the next 20 years, the baby boomer generation. Therefore it’s necessary to innovate with alternatives to long term care. In Louisiana there are 18 thousand people on a waiting list hoping for an opportunity to stay in their community through home base programs.

RON HARRIS [continued]: Louisiana Answers for a Living at Home was a state pilot program designed to provide options for aging in place. The pilot program was designed to assist individuals who are at imminent risk for nursing home placement but not eligible for Medicaid. To have the choice of avoiding nursing home placement and spend down to Medicaid. Basically people are being required to become poor so that they can go into a retirement home

RON HARRIS [continued]: where they don’t want to be anyway. [Know About Strategies for Aging in Place]

RON HARRIS: Aging in place is considered to be the most desirable way to age by maintaining connection in a community and obtaining support for an autonomous lifestyle. When they are successful aging in place strategies minimize the provision of inappropriate care. [Learn About Cost Analysis for Evaluation]

RON HARRIS: Cost analysis is among the quantitative methods for analyzing the data collected in evaluation research. I conducted a cost analysis of a pilot program called Louisiana Answers for a Living at Home to evaluate the options for older adults to age in place. The types of services provided by this community living

RON HARRIS [continued]: program where transportation, home delivered meals, a homemaker to come in and service the home, maintain cleanliness and hygiene, look for fall causing agents, low lighting. Caregiver education was provided to the caregivers that provide services.

RON HARRIS [continued]: Acadian On Call is an ambulance service. They were available for elder people in their homes in case they had a medical emergency. Material aid was provided. One of the most important services that was provided was home modification. People in their homes they wanted to retire and needed to have a wheelchair ramp or they needed to have grab bars and bathrooms.

RON HARRIS [continued]: And so this was one of the services that would allow them to stay in their homes. Personal care services were provided. Respite for the caregivers. An older person would be able to go and stay in a community center and someone would have some time off from that. Charlie’s Place was one of those types of centers which specialized in care for Alzheimer’s patients.

RON HARRIS [continued]: And other chores that could be provided through service provision. Various contracts of services [Compare Program Costs With Alternatives]

RON HARRIS: The program costs were compared to alternative types of programs such as living in a nursing home. To spend down and to become eligible for Medicaid and be in a nursing home you would have to spend in the state of Louisiana at least spend $47,482 on an annual basis.

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RON HARRIS [continued]: Versus the Louisiana Answers for Living at Home Program we only had to spend $27,000 for someone to stay in their own residence where they would be happier. We had other programs that you could compare the EDA waiver program which was $34,000. Still the answers for living at home program

RON HARRIS [continued]: did better on those costs. [Conclusion]

RON HARRIS: In conclusion the program provides more services and flexible options for care than home health so that older residents can stay in their community. The program participants were extremely satisfied with the flexibility to manage their own resources to obtain preferred services. The program appears cost effective when compared with alternative programs such as Medicaid

RON HARRIS [continued]: in a skilled nursing facility. Why is this program important? Well as I mentioned we are running out of resources to support our aging population. By about 2030 we’re going to run out of funds from Medicare and Medicaid and social security unless we raise taxes or we find some other way grow the economy. Healthcare Management Costs & the Aging Population

RON HARRIS [continued]: What impact will this have on your future? Many of the people that participated in this pilot program complained that in retirement they have to sustain three generations. They’re taking care of their parents who are still not passed on. They’re taking care of their own children and sometimes grandchildren. So this is important to you. If you want to read more about this study

RON HARRIS [continued]: I have an article called Louisiana Answers for a Living at Home, State pilot program for aging in place that was published in the international journal of aging in society. And then in the governor’s office of elderly affairs there is a final evaluation report that I wrote called Louisiana Answers for Living at Home. Healthcare Management Costs & the Aging Population