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Photo credit: The John A. Hartford Foundation

Across the nation, innovative care models are making a real difference in the quality of care we receive as we age.

And many more are in various stages of development and dissemination. Grantmakers already investing in health care have a vital role to play in making better, patient-centered care for all people, including older people, the standard.

Here are just a few examples of initiatives grantmakers are funding that are moving us closer to realizing that goal:

The Institute for Healthcare Improvement (IHI) is partnering on an age-friendly health systems initiative with The John A. Hartford Foundation, which is supporting the work with a $3.2 million grant. The project focuses on four high-level interventions, referred to as the “4 Ms:” What Matters, Mobility, Medications, and the Mentation of older adults. The model is already in the testing phase at five U.S. health systems, with the intention of then scaling up the most effective practices throughout their organizations. The five systems are generating tools and techniques that will in turn enable greater adoption by a wider community of providers, as the initiative advances to meet its goal of spreading the age-friendly health systems model to 20 percent of hospitals and health systems by 2020. Grantmakers could consider partnering to implement the model at a local hospital or health system as it is disseminated.

A promising primary care model, the Patient-Centered Medical Home, is being spread in the state of Idaho with support from Cambia Health Foundation. Most recently, Cambia awarded a $334,800 grant over 18 months to the Idaho Primary Care Association to pilot different models of oral health integration in the Patient Centered Medical Home primary care setting. Four health centers will pilot different models of oral health integration to determine feasibility in different medical settings and with different populations. This grant follows a three-year, $300,000 grant awarded in 2013 that supported efforts to transform community health center clinics into Patient Centered Medical Homes.

In San Diego, the Gary and Mary West Foundation funded the integration of oral health care for older adults with the launch of the Gary and Mary West Senior Dental Centerin October 2016. The state-of-the-art community dental clinic in part of a suite of clinical and non-clinical services provided at the Gary and Mary West Senior Wellness Center, the flagship facility of Serving Seniors, a San Diego-based nonprofit organization. The Gary and Mary West Foundation awarded a $3 million grant to Serving Seniors in 2008 to help build the Wellness Center, a community-based care model that provides low-income older adults two meals a day and access to more than 30 nonprofit organizations and support services.

Hip fractures are one of the leading health risks we face as we age. They hospitalize more than 260,000 older adults annually, and could hospitalize 500,000 older adults each year by 2040. A national program, launched by the American Geriatrics Society (AGS) with $1.4 million in support from The John A. Hartford Foundation, positions geriatricians and geriatrics-trained clinicians as co-managers with orthopedic surgeons to improve care and health outcomes for older adults with hip fractures. The project, AGS CoCare: Ortho, has a proven track record of benefits, including: shorter time to surgery; reduced length of stay; reduced 30-day re-hospitalization; reduced complications and enhanced function after the person returns home; and institutional cost savings, among others. An earlier planning grant from The John A. Hartford Foundation allowed the AGS to develop a viable business strategy and implementation plan to disseminate the geriatrics-orthopedics co-management model to hospitals and health systems nationwide. Grantmakers could consider partnering to implement AGS CoCare: Ortho at local health systems or hospitals.

Under its Depression in Late Life initiative, the Archstone Foundation is funding a partnership to deliver collaborative care for people over 65 who suffer from depression. The foundation is partnering with the University of Washington AIMS Center and the University of California, Davis to implement Care Partners: Bridging Families, Clinics, and Communities to Advance Late-Life Depression Care, which will fund innovative approaches to treating depression in older adults through community-engaged partnerships. The Archstone Foundation recently awarded a four-year grant of almost $3.3 million to the University of Washington to support technical assistance, training, and evaluation for Phase 2 of the Care Partners project.

Employing telehealth solutions to improve access to care is another promising path forward. The California Health Care Foundation (CHCF) has awarded a $1.3 million grant to the Center for Care Innovations to team up with the California Telehealth Resource Center to develop sustainable models of telehealth to improve low-income Californians’ access to specialty care. The Sustainable Models of Telehealth in the Safety Net program is partnering with three to five Medi-Cal managed care plans and up to 20 safety net organizations, and are testing if telehealth programs can flourish in safety net settings with the staffing support, technical assistance necessary to achieve greater referral volume, and a consistent and predictable payment from health plans. The program provides participating teams with on-site training, ongoing technical assistance, and a learning community to share lessons and best practices with other implementation sites across the country.

The Playbook for Better Care is an excellent example of grantmakers working together to accelerate health system transformation regarding the social determinants of health. Five foundations—The Commonwealth Fund, The John A. Hartford Foundation, Peterson Center on Healthcare, the Robert Wood Johnson Foundation, and The SCAN Foundation—collaborated with the Institute for Healthcare Improvement (IHI) to develop The Playbook. The site provides evidence-based or experience-informed ideas about how to address the challenges facing adults with complex health and social needs, and is essential reading for funders considering opportunities to improve care for them.

In communities across America, older adults with dementia need additional support and their families need assistance accessing resources to help them navigate the challenges associated with Alzheimer’s disease. The Tufts Health Plan Foundation awarded a two-year, $240,875 grant to the Alzheimer’s Association, Massachusetts/New Hampshire to expand a program to train first responders, nonemergency government employees, and allied health professionals to better understand the needs of those living with dementia. Professionals who will receive training through the grant include firefighters, municipal employees, nurses, and social workers across Massachusetts.

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