Every day, 11,000 seniors become eligible for Medicare. How can health systems prepare to support this growing population’s future needs? To help seniors manage functional decline and proactively plan for future care, some organizations have implemented outpatient geriatric assessment centers.
These centers offer comprehensive, multidisciplinary evaluations and treatment plans for complex, elderly patients. While recent studies of this approach have not demonstrated reductions in hospitalizations or total Medicare costs, they have found significant improvements in seniors’ quality of life and living independence.
What is an outpatient geriatric assessment center?
Integrating behavioral health care with appropriate and cost-effective outpatient sites of service, such as partnerships and telemedicine, is becoming a bigger priority for hospitals. There is latent demand for behavioral health care—up to 30% of the population has a mental health condition but less than 25% of them receive appropriate care. In addition, the number of people eligible for and in need of behavioral health services will grow due to the Mental Health Parity law and increased coverage through health reform.
Historically, most hospitals have not focused on growing behavioral health services, and behavioral health service lines are rare. Since the inpatient delivery of behavioral health care is cost-prohibitive, any effort to grow behavioral services is better aimed by creating a broad spectrum of outpatient services. As service lines shift to include more consideration of settings beyond acute care and also embed themselves in efforts to improve population health, behavioral health services may find its place in the realm of service lines.
Behavioral health care delivery: Innovative strategies for off-site service
The GRACE model
Geriatric Resources for Assessment and Care of Elders (GRACE) is an outpatient care model used by institutions to improve care management and coordination for complex, elderly, and low-income patients. The program assigns patients a support team that includes a nurse practitioner (NP) and social worker, as well as a geriatrician-led interdisciplinary care team that includes a pharmacist, physical therapist, and mental health professional.
Nurse practitioners and social workers make up the core of the GRACE care team. They meet with enrollees during an initial in-home assessment designed to evaluate the patient’s health status, living conditions, and other factors that can influence their health needs, reporting their findings to the interdisciplinary care team.
Evaluating the GRACE model