Rethinking Eldercare Services

Along with navigating the challenges of having sufficient income to support retirement, most older adults will need supportive services to recover from periods of illness or other temporary setbacks, and many will have chronic medical conditions that result in gradually worsening disability. Some of us will require hundreds of thousands of dollars in long-term care services over an extended period. Whatever the pattern, a mix of health care and supportive services tailored to individual needs and preferences is the goal.

But our care delivery system isn’t there yet, and exogenous factors, including Covid-19, are producing major impacts and creating new challenges. Against this backdrop, we face questions: For example, how we can adapt current payment and service delivery programs and models to do a better job of organizing high-quality services? How can we provide services that older adults with disabilities need at a cost they can afford? How can society use existing programs to more efficiently plan for and organize services for a fast-rising elderly population? Other priorities include how we can improve the residential long-term care sector so that it is both as safe as possible, while offering elders a good quality of life, and how to expand capacity to offer home and community-based services for tens of millions of Americans who aspire to age in place.

Working with partners around the country, Altarum offers a range of specialists and analysts working on quality improvement, policy initiatives and models of reform that highlight best practices and how they can be more widely implemented. The Center for Eldercare Improvement has deep roots in designing and facilitating policy change, and in leveraging policy to help create broad public commitment to high-quality care.

Here’s some of what we work on:

Wider implementation of comprehensive culture change in nursing homes;
Expanded volunteer help for family caregivers, older adults, and individuals with disabilities living in community settings;
Policy initiatives that incentivize states to implement more robust home and community-based services systems for older adults and individuals with disabilities;
Broadening service delivery options for older adults with disabilities; and
Creating measures and indicators that track how well providers are serving elders living in a given geographic area.

Featured Eldercare Work

Solutions

Expanding Access to Long-Term Supportive Services

Altarum is implementing a new model of care for elders that ensures they receive the care they need to live comfortably at an affordable cost.

Managing Care of Dual-Eligible Beneficiaries

We created an application that renders patient care plans from a consolidated-clinical document architecture, facilitating care coordination among dual-eligibles.

Improving Quality of Life for Nursing Home Residents Through a Culture Change Initiative

Altarum is evaluating a culture change initiative in six nursing homes in Michigan.

News and Perspectives

PACE is the Place—An Overview of Highlights and Expert Insights on Expanding a High-Performing Program and Model of Care

Read an overview of the event and glean expert insights on how necessity is sparking innovation and growth, how proper evaluation and expanded policies can bolster the program’s impact, and how the future of PACE can build on what already makes the model exceptional.

PACE—Did This Geriatric Gem Sparkle for Older Adults During the Pandemic?

What does a shift from center- to home-based care look like? Three-quarters of PACE organizations told us how they responded to Covid-19. Learn more about their agile responses, like providing groceries and meals, activity kits, and even overnight stays.

Survey of Nursing Home Residents Reveals Deep Emotional Toll of Social Isolation Under Covid-19

A new survey of nursing home residents by Altarum provides a rare glimpse into how Covid-19 restrictions of nursing facilities have impacted nearly every aspect of resident life and led to the unintended consequence of drastically reducing frail elders’ connection to community and family, a fundamental human need.

Publications

Michigan's Long-Term Care Workforce: Needs, Strengths, and Challenges

This report offers recommendations to fortify the direct care workforce, which is challenged by low and stagnant wages despite robust demand and job growth.

Experiences of Nursing Home Residents During the Covid-19 Pandemic

This survey of nursing home residents provides a rare glimpse into how life has changed under Covid-19, and the emotional toll it has taken on frail elders. It also includes recommendations for nursing homes and policymakers.

Program to Improve Eldercare—Issue Briefs

This collection of issue briefs examine the impact of various social determinants of health (housing, transportation, workforce and more) on long-term services and supports for the elderly—and offers strategies to address them.

Contact Us

Anne Montgomery - MS

Program Director, Delivery System Transformation

Areas of Expertise

Long-Term Services and Supports
Medicare, Medicaid, the Older Americans Act, and other programs
Social Determinants of Health in Older Adults

Anne Montgomery develops policy and research initiatives that improve long-term services and supports and medical care for older adults receiving services from Medicare, Medicaid, the Older Americans Act, and other programs. She is co-leading efforts to implement and evaluate comprehensive culture change and quality improvement in nursing homes and is working with colleagues to develop a new volunteer-based Community Care Corps program at the national level. Anne conducts workforce policy analysis for home and community-based services (HCBS) and advises on how to expand models of community-based care for older adults requiring complex services.

Sarah Slocum - MA