Witnesses At Senate Aging Committee Hearing Call For 'Person-Centered' Care For Elderly

Main Category: Seniors / Aging
Also Included In: Caregivers / Homecare
Article Date: 28 Jul 2008 - 4:00 PST

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Witnesses on Wednesday at a Senate Committee on Aging hearing on efforts to improve care for the elderly cited the need for a focus on "person-centered" models, CQ HealthBeat reports. During the hearing, Robert Jenkens, director of the Green House Project, discussed the "Green House model," which he said "reinvents nursing homes to make them real homes" through a combination of "small houses with the full range of personal care and clinical services needed by elders typically served in skilled nursing facilities."

Most Green House homes have 10 elderly residents and include private and community areas, Jenkens said, adding, "The design creates a therapeutic environment, encouraging self-reliance through short distances and a safe environment for elders." The Green House Project is a not-for-profit that relies on funds from the Robert Wood Johnson Foundation and Medicaid reimbursement. Jenkens asked the committee to accelerate federal reviews of proposed revisions to state Medicaid programs that would promote the establishment of Green House homes.

According to Jenkens, Green House homes currently serve only elderly residents in states with higher reimbursement rates, as the model requires "slightly more direct care staff than the industry average" and because "many state reimbursement rates cover only a small percentage of the actual capital costs." He also asked the committee to pass legislation to provide tax credits, targeted grants and interest rate reductions to make capital costs for Green House homes more manageable.

'Medical Home' Model
Melinda Abrams, assistant vice president of the Commonwealth Fund, discussed the "medical home" model, in which primary care physicians receive extra payments to oversee and coordinate care for patients with chronic diseases. She said, "In a medical home, care coordination is vastly improved. The primary care clinician helps the patient select a specialist, and with support from staff, proactively follows up with both the providers and the patients."

In addition, the "personal physician reviews treatment options with the patient and her family to help understand or resolve conflicting advice received from multiple providers," Abrams said. She added that implementation of the medical home model requires "fundamental payment reform that is intended to strengthen and reward primary care" (Reichard, CQ HealthBeat, 7/23).

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