IOM’s “Retooling For An Aging America” Seen As Turning Point In Efforts To Improve Healthcare For Older Adults

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The recent release of “Retooling for an Aging America” — the Institute of Medicine (IOM) report warning that the nation’s healthcare workforce is too small and unprepared for care for the aging population and calling for sweeping changes to avert this looming healthcare crisis — could be a turning point in elder healthcare in this country, according experts who spoke at the American Geriatrics Society’s 2008 Scientific Meeting last week. The AGS meeting, which ran from April 30 through May 4 in Washington, DC, is the premier scientific meeting for clinical aging research.

The April 14 IOM report could spur significant changes in policy and healthcare systems that improve care and result in savings, agreed members of a panel that included the chair of the IOM committee that drafted the report, and AGS President John B. Murphy, MD, professor of medicine and family medicine at Brown University’s Warren Alpert Medical School and Chief Physician Officer at Rhode Island Hospital. For this to happen, however, advocates of higher quality and more cost-effective care need to build on the report’s findings, and, most important, press policymakers for change, the panelists concurred.

“AGS is already working toward this goal in a variety of ways,” said Dr. Murphy who took the helm as AGS President during the annual meeting.
The week the report was released, AGS Board Chair Todd Semla, PharmD, testified before the Senate Special Committee on Aging, urging Congress to address widespread shortcomings in the US healthcare system that are impediments to quality, cost-effective elder healthcare. Many of the recommendations he outlined – and for which AGS has long advocated – parallel those in the IOM report.
Previous IOM reports, including “To Err is Human: Building a Safer Health System,” and “Crossing the Quality Chasm: A New Health System for the 21st Century,” have led to significant changes in healthcare policy and delivery. With “Retooling for An Aging America,” the indicators to date have been promising, those at the AGS symposium agreed.

“I’ve been delighted by the response, including the Senate Special Committee on Aging hearing and the tremendous amount of print, radio, and TV attention (the report has) received,” said John W. Rowe, MD, who chaired the IOM committee that drafted the report and was a member of the AGS panel. But making real progress will require a concerted effort by everyone committed to ensuring higher quality care for older adults, he and other speakers agreed. “We need everyone, including everyone here, to talk with people who can be influential, and bring this message to policy makers,” Dr. Rowe said.

AGS advocated for the IOM study, and, with the John A. Hartford Foundation, the Atlantic Philanthropies and other foundations, helped generate support to fund it. Several AGS members also sat on the IOM committee that drafted the report.

“Retooling for an Aging America” recommends that:

– Pubic and private payers offer a “specific enhancement of reimbursement” for healthcare services to older adults provided by practitioners with a “certification of special expertise in geriatrics.”

– state and federal governments offer loan forgiveness, scholarships and other financing incentives to professionals who specialize in geriatrics

– Congress expand the Geriatric Academic Career Award program to support junior geriatrics faculty in other health professions in addition to medicine

– states and the federal government increase minimum training standards for all direct care workers

– state Medicaid programs increase pay and benefits for direct care workers, who are poorly paid and often lack basic benefits, to improve recruitment and retention of these workers

– public, private and community organizations provide funding and ensure adequate training for family and other informal caregivers

– Congress and foundations “significantly increase” support for research and demonstration programs that lead to development of new models of care in areas such as prevention, long-term and palliative care, and models of care that promote the effective uses of the workforce

– public and private payers promote and reward new models of care for older adults that are shown to be effective and efficient. This might include coverage of key services, such as care coordination, that are currently not covered but are integral to quality care and may result in both improved outcomes and savings

– healthcare professionals and regulators consider expanding the roles and responsibilities of healthcare providers to better meet the needs of an aging population

‘We have to take this report and run with it,” Dr. Murphy urged those at the symposium. “When you get back home, take the message to your hospital boards, legislators, newspapers. We need the voters talking to their senators about this. This is a golden opportunity. We can’t let this die on the vine. “