Transforming_Health_Care_SS__400pLast week’s meeting of the John A. Hartford Foundation’s Board of Trustees was an important and exciting time for us all.

It was the first board meeting under the direction of our new President, Terry Fulmer, PhD, RN, FAAN, and it was the last board meeting for our long-time board chair, Norman H. Volk, who is succeeded by Margaret Wolff. Demonstrating the John A. Hartford Foundation’s commitment to our current strategies to create widespread and systemic practice change in health care, the Trustees approved $10.3 million in six new grants to improve the health of older adults, our largest authorization in many years.

The new grants add muscle to four of our five funding areas comprising the Foundation’s current strategic plan. And our fifth strategy, Interprofessional Leadership in Action, is certainly validated by these projects, most of which are the culmination of several years—sometimes decades—of work by leaders in the field of aging and health who we have helped develop and support.

Three of the new grants fall in our Models of Care portfolio, which develops, tests, and spreads innovations that improve older adult health outcomes while lowering health care costs. This includes funding for the second phase in the development of the Carealign model, a vanguard effort to redesign primary and specialty care around what really matters to older adults with complex medical conditions. This means identifying patient’s own health outcome goals and care preferences and then “re”aligning the clinical decisions of multiple providers to meet them. The model, which is being developed with input from more than 150 individual and organizational stakeholders including patient and family caregiver groups, will be prototyped, refined, and evaluated in ProHealth, the largest primary care provider group in the state of Connecticut, under the direction of long-time grantees, Mary Tinetti, MD, of Yale and Caroline Blaum, MD, of NYU.

Y_logo_150Also in the Models of Care portfolio is a grant project that has forged a new partnership between the Foundation and the Y-USA to address one of the nation’s most pressing health challenges: Type-2 diabetes, which is among the most far-reaching, fastest growing, and costly of chronic diseases. Almost half of all older adults, or more than 86 million people over age 65, have pre-diabetes. This grant will help spread the CDC-approved and rigorously tested Diabetes Prevention Program to help as many of those susceptible to diabetes as possible avoid full onset of the disease. We are excited that YMCAs and their national organization are giving more attention to older adults in their communities as a partner in our efforts to better coordinate community resources and health care to improve the lives of older Americans.

Read the press release for full details on our new Y partnership.

The third Model of Care grant will augment our current support of the University of Washington Advancing Integrated Mental Health Solutions (AIMS) Center to continue spreading the Collaborative Care/IMPACT model of depression care in low-income primary care clinics in the rural northwest through our federal Social Innovation Fund award. Specifically, the project will enable AIMS to produce a more comprehensive evaluation, develop mobile aps and other tools to support patient engagement, and foster the sustainability of the model at the eight clinics in Alaska, Wyoming, Washington, and Montana.

ACS_logo_300pIn our Tools and Measures for Quality Care strategy area, we are building on decades of work with surgeons, anesthesiologists, and other specialists to create standards, measures, and a quality improvement program for surgical care of older adults through a partnership with the American College of Surgeons. This initiative will develop a program to verify that hospitals across the country can deliver optimal surgical care to older adults, much the way that the College verifies that trauma centers have the right staffing, resources, and other infrastructure that evidence shows saves lives. With interprofessional engagement and the involvement of patient and family organizations, the four-year initiative will not only set standards, but also identify and develop new person-centered measures of quality for older adults that can help hospitals continuously track surgical outcomes and improve them.

At the College, the project will be led by Clifford Ko, MD, director of the Division of Research and Optimal Patient Care. While at UCLA, Dr. Ko was a 2003 Jahnigen Scholar supported by the John A. Hartford Foundation to pursue his passion in improving the quality of care for older adult surgical patients.

Read the press release for full details on our partnership with the American College of Surgeons.

AGS-arc_200pAlso in the surgical arena, a planning grant has been awarded to the American Geriatrics Society to create a business strategy and implementation plan for a Geriatrics-Orthopedic Co-management Intervention for hip-fracture patients. Co-management between surgeons and geriatricians or other clinicians with geriatrics expertise to provide pre- and post-operative care produces better outcomes for older adults, but has not yet been widely adopted. By better understanding and showing hospitals the financial benefits of co-management, and with new standards being developed for surgical care, we believe this type of best practice will be replicated more widely.

Since the crux of the model is about bringing the best of what is known in geriatric medicine to a broader practice setting, this grant fits well within our Linking Education and Practice portfolio. The project will be led by Richard Besdine, MD, and William Hall, MD, long-time leaders in geriatric medicine and directors of John A. Hartford Foundation-sponsored Centers of Excellence at Brown and Rochester, respectively.

NHPFlogo250Finally, in our fifth strategy area of Policy and Communications, we are renewing our long-time support for the National Health Policy Forum, which provides a venue for bi-partisan dialogue and unbiased, expert-driven educational sessions and products for congressional and executive branch staff in DC. Given the ongoing effort to refine health policy and the transitions following the 2016 elections, the Foundation is proud to support this critical resource for effective health policy decision making.

Our policy grant to the Forum, and all of the above initiatives, are in some way responding to the changing health care landscape and the shift of federal health and long-term care payments for older adults from “volume to value.” We will continue to seize opportunities that the environment presents, work with familiar and new leaders in the field of aging and health, and bring forward more grants that can transform health care for older adults.