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RAHF Supports "CAPABLE: Scaling for Impact" Program

by: Linda Le | Mon, Dec 10, 2018 |

RITA & ALEX HILLMAN FOUNDATION ANNOUNCES ITS
LARGEST-EVER GRANT TO A SINGLE NURSING-DRIVEN INNOVATION

Award will support national scaling of highly successful CAPABLE program for aging in place

New York, NY – (December 11, 2018) – Affirming its commitment to developing and disseminating innovative models of care that meet the needs of vulnerable and underserved people, the Rita & Alex Hillman Foundation (RAHF) today announced the largest grant to a single nursing-driven innovation in the foundation’s history, awarding nearly $3 million to the CAPABLE project and Principal Investigator (PI) Sarah Szanton, PhD, ANP, FAAN. 

Dr. Szanton came up with the idea for CAPABLE (Community Aging in Place–Advancing Better for Living) after making house calls as a nurse practitioner to homebound, low-income, elderly patients in West Baltimore and observing that environmental challenges were often as pressing as health challenges, particularly for those trying to “age in place” or stay out of a nursing home. The model was then developed in close collaboration with Laura Gitlin, PhD, and other colleagues at the Johns Hopkins School of Nursing. Dr. Szanton is Endowed Professor for Health Equity and Social Justice and Director of the Center for Innovative Care in Aging at the Johns Hopkins School of Nursing and a respected nurse innovator and researcher. 

The five-year RAHF award totals $2,849,753 and will allow CAPABLE to establish the infrastructure required to scale the model (already in use at 25 sites in 12 states) on a national level.  

"We believe that CAPABLE has the potential to have a major impact on millions of lives,” said Ahrin Mishan, Executive Director of the Rita & Alex Hillman Foundation. “Having supported CAPABLE through earlier phases of its growth and development, we feel privileged to help this exceptional innovation take a critical next step.”

Using an interdisciplinary approach, CAPABLE combines handyman services for home repairs that improve safety and accessibility with nursing and occupational therapy services that improve mobility, reduce disability, and decrease health care costs. 

“CAPABLE is built on the simple but powerful idea that addressing what matters most to older adults improves quality of life and saves money for communities,” said PI Sarah Szanton. “This transformative gift from the Rita and Alex Hillman Foundation will facilitate the accelerated growth of the model nationwide.”

CAPABLE improves quality of life, aligns with health finance reform, saves money
An evidence-based program, CAPABLE combines several strengths, including its ability to improve participants’ quality of life. For example, the program has been shown to reduce by half the difficulties participants have with function and mobility, to improve the ability to do grocery shopping and manage medications, to increase motivation, and to reduce symptoms of depression.

The model also aligns well with new opportunities in health care financing. Its services are eligible to be covered in some states under Medicaid Section 1115 waivers; for example, a new Medicaid waiver recently approved for Massachusetts could make CAPABLE available to an additional 12,000 people in that state. The program is also available in some instances through Medicare, as Medicare Advantage plans (which cover one out of three Medicare beneficiaries over age 65) can also now cover some “non-medical” expenses.

CAPABLE has also been proven cost effective, with a six-fold return on investment, according to randomized controlled trials and evaluation by the Centers for Medicare and Medicaid Services (CMS). The intervention costs less than $3,000 per participant but yields at least $20,000 in Medicare savings per participant over two years through decreases in hospitalizations, re-hospitalizations, and nursing home admissions. 

If CAPABLE were scaled nationally, it is estimated that the program could save Medicare $6.8 billion annually, even if only one third of eligible older adults participated and the program saved only half as much as it did in the original trial.

 

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