Care for seniors through Medicare has always been focused on a medical model of illness versus wellness. Tracking ER visits and re hospitalization rates have been a primary way at looking at the efficacy of care. CMS (Center for Medicare and Medicaid Services) has made the decision to finally look beyond straight medical needs alone and acknowledge that the person’s (patient’s) home is part of the continuum of care.

What does that mean? A new reality is that some Medicare Advantage plans (Part C) can cover the costs for equipment to make the home safer and more accessible.  It is premature to hail this as the ultimate answer to those seniors  who want or need to age in their original homes.  Kaiser Health News announced that 35% of the new enrollees for Medicare Advantage plans in Michigan have elected this coverage. It will be interesting to see what actually materializes in peoples’ homes to make homes safer and more comfortable

Other good news, the CAPABLE program started through a pilot project for CMS in 2010 at John Hopkins in Baltimore has just received over 3 million dollars of private foundation money to expand the program beyond the 12 states where it now operates.  CAPABLE stands for Community Aging in Place Advancing Better Living for Elders.  The essence of it is specially trained Nurses and Occupational Therapists. They form a team to go out on multiple visits to low income seniors’ homes to listen and assess the strengths and needs. Together with the home owner they identify mobility and fall challenges along with recognizes how pain, mood and strength issue add up to a definable intervention. It also can mean suggested ways to become more social and active outside the home. A handyman (person) then comes in to make changes in the home, think grab bars, ramps and fixing hazardous stairs etc. There is followup to assess the homeowners satisfaction with the program. 

Again the proactive aspect of these two different programs are major steps forward.