A Community Partnership to House and Care for Complex Patients

Reconceptualizing family caregivers as part of the health care team

“…Considering the caregiver as part of the health care team has strong implications for understanding team dynamics in care delivery. In a recent study, health care executives, clinical leaders, and clinicians indicated that unpaid caregivers should be viewed as members of the care team, though they tend to get far less support and recognition than deserved (6). Traditionally, health care teams are interdisciplinary, with varied roles and responsibilities allocated based on professional background and training (14).…”

“…One policy, the Caregiver Advise, Record, Enable (CARE) Act, was developed by AARP, then introduced to state legislatures, and is intended to provide designated caregivers with discharge instructions and guidance. The CARE Act, now signed into law by 40 states, aims to provide health care providers with practices that integrate caregivers into the process of care delivery, but has failed to be broadly implemented within health care organizations (6). A national survey of health care executives, clinical leaders, and clinicians about caring for caregivers found that 79% of respondents are either not very familiar or not at all familiar with the CARE Act (6).…”

“…The CARE Act, now signed into law by 40 states, aims to provide health care providers with practices that integrate caregivers into the process of care delivery, but has failed to be broadly implemented within health care organizations (6). A national survey of health care executives, clinical leaders, and clinicians about caring for caregivers found that 79% of respondents are either not very familiar or not at all familiar with the CARE Act (6). Medicaid waivers are intended to provide caregivers with training and, in some cases, compensation; yet these efforts are uncoordinated across the U.S. (5).…”

All you need is love: Yet another social determinant of health

“…21 If the FDA approval is not reversed, it is estimated that aducanumab will cost Medicare between 29 and 57 billion dollars per year 22 -enough to eliminate food insecurity ($30 million) 23 and poverty ($390 million) 24 for every older adult more than 70 times over. 25 Gesturing towards recognition of the gap between spending and root causes, some commercial payers, 26 Medicare Special Needs Plans launched by housing organizations, 27 Medicaid Managed Care plans, 28 and a few health systems, 29 have begun to act on remediating social factors (such as lack of food and housing) driving poor health. Without government action to bring these initiatives to scale, however, these constitute more examples of admiring the problem, rather than solving it.…”

“…Gesturing towards recognition of the gap between spending and root causes, some commercial payers, 26 Medicare Special Needs Plans launched by housing organizations, 27 Medicaid Managed Care plans, 28 and a few health systems, 29 have begun to act on remediating social factors (such as lack of food and housing) driving poor health. Without government action to bring these initiatives to scale, however, these constitute more examples of admiring the problem, rather than solving it.…”