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The Roger C. Lipitz Center for Integrated Health Care

Keyword: models of care

Evaluation of Hospice Enrollment and Family and Unpaid Caregivers’ Experiences With Health Care Workers in the Care of Older Adults During the Last Month of Life

A study by Jennifer Wolff, Vicki Freedman, Katherine Ornstein, John Mulcahy, and Judith Kasper in JAMA Network Open uses NHATS and NSOC data to evaluate family and unpaid caregivers’ experiences with health care workers while caring for an older adult near the end of life. Findings suggest end-of-life caregivers commonly assisted with symptom management, participated in medical decision-making, and generally reported favorable experiences communicating with health care workers. However, 1 in 3 were never asked by health care workers if they needed help managing care and just half of caregivers assisting with symptom management received training. 

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Affording Genetic Therapies in the Medicaid Program

A study by Jeromie Ballreich, Ijeamaka Ezebilo, and Joshua Sharfstein in JAMA Pediatrics explores potential solutions to the challenge of the high cost of genetic therapies and other specialty drugs for diseases of childhood. Findings suggest a pooled subscription model negotiated across therapies and Medicaid programs may allow manufacturers to focus on the cooperation necessary for the administration of these complex therapies and help achieve the shared public and private goal of assuring access to care. 

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The Common Attributes of Successful Care Manager Programs for High-Need, High-Cost Persons: A Cross-Case Analysis.

Thurber EGBoyd CLeff BWolff JAnderson G


Many programs use care managers to improve care coordination for high-need, high-cost patient populations. However, little is known about how programs integrate care managers into care delivery or the attributes shared by successful programs. We used a case study approach to examine the common attributes of 10 programs for high-need, high-cost individuals utilizing a longitudinal care manager that had achieved success in reducing cost, improving quality, or increasing patient satisfaction. Through interviews with program leaders and document review, we identified 10 common attributes of successful care manager programs, offering insights for providers aiming to better serve the high-need, high-cost population.

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Reduced Lower Extremity Functioning Is Associated With an Increased Rate of Being a Nondriver: The National Health and Aging Trends Study

In the United States and other industrialized countries, driving is an important component of independent mobility for adults. Driving connects adults with many fundamental aspects of daily life such as employment, social engagements, and personal care. As the number of older adult drivers increases, health professionals play an important role in keeping older drivers safely on the road, for example, by providing rehabilitative and prevention services for correctable problems such as musculoskeletal strength. If the physical therapy profession is going to “transform society by optimizing movement to improve the human experience,”, it is arguable that maintaining independent and safe driving mobility is a goal for physical therapy. ...Read More

Effect of a Biobehavioral Environmental Approach on Disability Among Low-Income Older Adults

Study by Sarah Szanton, Qian-Li Xue, Bruce Leff; Jack Guralnik, Jennifer Wolff, Ibby Tanner, Cynthia Boyd, Roland Thorpe, David Bishai and Laura Gitlin demonstrates that CAPABLE, a home based intervention reduced disability by 30% compared to a control group also receiving home visits. This work was recently awarded a $3 million grant from the Rita & Alex Hillman Foundation to scale the CAPABLE program beyond the 26 places in 12 States it is already operating. ...Read More

The Promise and Pitfalls of the CHRONIC Care Act

The CHRONIC Care Act will allow insurance companies offering Medicare Advantage plans to pay for non-medical supplementary benefits to prevent an illness or injury. Amber Willink and Eva DuGoff co-authored a perspective in the New England Journal of Medicine that describes the implications of the Act for expanding access to non-medical services....Read More

Consideration of dental, vision, and hearing services to be covered under Medicare

Amber Willink, Cathy Schoen, Karen Davis

Since 1965, Medicare has been an important source of financial protection from medical expenses for older adults in the US. Coverage of medical expenses by Medicare has always excluded dental, vision, and hearing services, leaving Medicare beneficiaries vulnerable to the high costs of these services...Read More