The Medicare Innovations Collaborative (Med-IC) was formed in 2007 with the goal of developing a strategy and implementation plan for a national technical assistance program to improve access to, and effectiveness of, geriatrics care in the United States. Using a planning grant from The Atlantic Philanthropies, we developed the hypothesis that acute care and transitional models of care could be bundled into a portfolio of senior services for hospitals to successfully care for Medicare patients. This "service line" or "portfolio" model would target mid-size hospitals that suffer economic disadvantages from low-profit-margin Medicare medical cases.
In late 2008, we renewed our grant with Atlantic and, using what we learned, revised our strategic direction. Today, the goal of Med-IC is to advocate and affect changes in healthcare policy by focusing on efforts to improve healthcare delivery for complex multimorbid adults in the inpatient setting. We are currently working on a pilot project to identify and recruit a small number of hospitals or health systems that have demonstrated readiness to develop a geriatric service line. Through these "learning laboratories," Med-IC will review and implement several innovative geriatric care models and will document learnings through manuscripts, working papers, and journals to advance the improvement of care for geriatric populations. We will also identify policy and payment barriers and enablers at all steps of development, creating a feedback loop that will inform health policy and advocacy.
A Portfolio Approach
Ultimately, the best models studied in the pilot project will be incorporated into a portfolio of geriatric clinical services that include prehospital, hospital, and posthospital components contributing to a continuum of care instead of individual silos of care. These services will share several conceptual elements, but will be customized to a hospital's local circumstances. Med-IC believes this will lead to improved care of patients with chronic illnesses. But just as important, we believe it will help hospitals remain competitive and profitable because they can care for this patient population more effectively. To read more about the business case for our portfolio approach, read our paper in the January/February 2009 issue of Health Affairs (PDF link).