Innovations of virginias aaa bay aging 2016 governors conference on aging
1. Designing Our Future
Improving Health Outcomes:
Innovations of Virginia’s
Area Agencies on Aging
May 2, 2016
Governor’s Conference on Aging
Kathy Vesley-
Massey
President/CEO
William Massey
CEO
2. Aging Facts – Around the
World• Between 2000 and 2050:
• the proportion of the world’s population over 60
years will double from about 11% to 22%
• the absolute increase – 605 million to 2 billion
• the world will have more people who live to see
their 80s or 90s than ever before
• the number of people aged 80 and older will
have almost quadrupled to 395 million
3. World vs United States
Proportion estimates of people aged 65 and older for 2010 and
2050
65+ by 2050
WORLD:
65+ in 2010
15.6%
7.7%
65+ by 2050
UNITED STATES:
65+ in 2010
21.4%
13.1%
2050 2010
• Countries with the largest growth: Japan, S. Korea, Spain, Italy and
France
• Countries with the least growth: Nigeria, Kenya, Pakistan, S. Africa,
Egypt
• United States ranks 11th highest growth in the world
4. The Changing Age Structure
• Overall age structure is projected to change greatly from 2010 –
2050
• Boomers are driving the change
• Who are these Boomers?
Baby
Boomers
were born
between the
years 1946
and 1964
Today,
40 million
people in
the U. S. are
65 and
older
which will
more than
double to 89
million by
2050
The “oldest
old” – those
people ages
85 and
older will
number 19
million by
2050
In other
words, by
2050
1in every 5
Americans
will be
65 and older
5. • Seniors have a new
definition of aging, attitude toward aging and interest in aging
• People are living longer thanks to changes in lifestyle and
technology
• A man reaching age 65 today can expect to live,
on average, until age 84.3
• A woman turning age 65 today can expect to
live, on average, until age 86.6
• One out of every four 65-year-olds today will
live past age 90, and one out of 10 will live past age 95
• More older adults will be living with disabilities
• Disease in old age is less likely to mean death or loss of
physical and mental function
Seniors are Redefining Aging
6. Life Expectancy at Age 65
Sex and calendar year, based on period life tables. Example: Life
expectancy at age 65 for males increased from 11.3 years in 1900 to 15.72
years in 2001
7. ANNUAL COST OF CHRONIC DISEASES
Data Source: CDC Cost Calculator for Virginia 2015. Includes costs only for diseases that are selected and have cost values available. The
projections: 1) are medical costs only, including nursing home costs but excluding absenteeism costs; 2) are based on default inputs; 3) are
reported in 2010 $ and do not project inflation; and 4) assume no changes in policy or technology and exclude changes due to the Affordable
Care Act. Virginia Department of Health.
8. Impact of the Aging
Population:
Area Agencies on Aging (AAAs)
Expertise
• 90% of people ages 65 and older want to stay in
their home for as long as possible
• 80% believe their current residence is where they
will always live
• Physical and service environments
must be accommodating for older
adults to age in place
• Village communities
• Alternative housing
AARP, National Conference of State Legislatures,
In Brief 190, December 2011
9. Eastern Virginia Care Transitions
Partnership
Centers for Medicare and Medicaid Services (CMS) demonstration for
Care Transitions Intervention (CTI) –
• to lower healthcare costs by lowering unnecessary Medicare
readmissions
• to improve the care experience
• to improve health outcomes
What is CTI?
• Hospital to home social / coaching model
• Empowers patient to take charge of their
health care
10. • Successful coalition of 11 hospitals and
5 AAAs
• Proven collaboration for CTI and other
pre & post acute “prevention”
interventions
• Measureable outcomes
• Foundation for additional contracts and
partnerships
• Launching point for statewide initiatives
Eastern Virginia Care Transitions
Partnership
11.
12.
13.
14. Innovations on Steroids
Virginia Center for Health Innovation
Partnership
• EVCTP recognized as statewide model for care
transitions
• Funding in State Innovation Model (SIM) grant for
Virginia to develop statewide AAA collaborative –
a one-stop shop
• AAA state model for better care and lower cost
for Medicare, Medicaid, emergency department
diversion and more
17. AAA Solution: Address Social
Determinants
• AAAs, already in the home, are equipped to address the social needs that
directly contribute to poor health and unnecessary health care utilization
• AAAs = Aging & Disability Resource Centers and No Wrong Door
• Arrange long-term care supports and services
• Meals on Wheels
• Transportation
• Home and Personal Care
• Medication Management
• Respite/Caregiver Support
• Housing
• Falls/Home Risk Assessments
• Options Counseling, Information and Assistance
• Senior Medicare Patrol to prevent fraud, waste and abuse
18. Other AAA Evidence-Based Innovations
Value Proposition: Bring Evidence-Based
Innovations into the Home -
• Healthy IDEAS (Behavioral Health)
• Chronic Disease Self-Management
• Advance Care Planning
• Matter of Balance: Fall Prevention
• Patient Activation Measure (PAM)
• Telehealth Pilots
• Chronic Pain Management
• HomeMeds and more
20. Summarizing the Value Proposition
Virginia AAAs have a very strong plan and portfolio –
• Diverse menu of traditional services (meals, transportation
…)
blended with a repertoire of innovative evidence-based
solutions
Key takeaways –
• Right care, at the right time, in the
right place
• Appropriate and timely prevention
and post-acute interventions
• Home-based care delivery
• Social determinants of health assessment and intervention
21. Virginia AAAs
● Unique! 25 AAAs consolidated goals and capacity
● Each has specialized capabilities, but there is a core
set
of competencies that can be delivered statewide
● There is a one-stop shop mechanism for statewide
contracting and performance monitoring
22. "We have come to “medicalize” aging, chronic illness,
frailty and death, treating them as if they were just
one more clinical problem to overcome. However, it
is not only medicine that is needed... but life, a life
with meaning, a life as rich and full as possible under
the circumstances."
Quote from Dr. Oliver Sacks
Being Mortal, Medicine and What Matters in the
End Atul Gawande, MD, MPH
23. • The Next Four Decades. The Older Population in the United States: 2010 to 2050. U.S. Census
Bureau.
• Pew Research. Global Attitudes Project. 2014.
• Projections of the Size and Composition of the U.S. Population. Population Estimates and
Projections. U.S. Department of Commerce, Economics and Statistics Organization, U.S.
Census Bureau.
• Aging in Place: A State Survey of Livability Policies and Practices. AARP. National Conference of
State Legislatures
• America’s Aging Population. Population Reference Bureau.
• Institute of Gerontology. A Growing Demand for Careers in Aging
• Virginia State Police: Report on the Impact of the Aging Population.
• Department of Homeland Security. Impact of an Aging Population on Fire and Emergency
Medical Services. 2013 Report to Congress.
• National Association of Area Agencies on Aging. Trends and New Directions: Area Agencies on
Aging Survey 2014.
• Virginia Employment Commission. Demographic Profiles.
• Center for Housing Policy. Housing an Aging Population. Are we Prepared?
• World Wide Learn. Five Biggest Trends Impacting the Job Market
• The Healthy Living Center of Excellence. Public Policy Framework for Improving Population
Health
• The Social Determinants of Health. Healthy People 2020 Approach. Department of Health.
• Aging and Life-Course. World Health Organization.
• Life Tables for the United States. Social Security.1900-2100. Actuarial Study No. 120.
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