Background
Among community-dwelling older adults who are eligible for both Medicare and Medicaid, over 60% have both chronic illnesses and functional limitations(1). Care management challenges for this population include high costs, fragmented care, and socioeconomic barriers (e.g. lower health literacy) (2). The Geriatric Resources for Assessment and Care of Elders (GRACE) care model was designed to address the unique challenges and unmet health needs of lower income older adults with both chronic illnesses and functional impairments.
The Goal of the Grace Model
The GRACE model is an innovative, home-based care management intervention that coordinates comprehensive, integrated primary care and social services for the target population(1, …show more content…
Moreover, the program reduced hospitalizations rates, which led to cost savings, even when accounting for program costs(4).
Limitations of the Evidence Supporting the GRACE Model
In contrast, research has not found the GRACE model to improve functional status or to reduce declines in functional status(4). Therefore, it is difficult to determine whether the model should incorporate more intensive approaches to improve functional status, or if a longer follow-up period (i.e. more than 3 years) is needed to identify changes in functional status resulting from the intervention(4).
Current or Potential Barriers to Implementing the GRACE Model
Currently, most of the services provided by the GRACE model are not reimbursable(2, 5), which is the primary barrier to the implementation of this model. More specifically, the GRACE model is only available in states where “medical home” or “advanced primary care” are being piloted, since the GRACE model can be incorporated into these pilots(5).
Among community-dwelling older adults who are eligible for both Medicare and Medicaid, over 60% have both chronic illnesses and functional limitations(1). Care management challenges for this population include high costs, fragmented care, and socioeconomic barriers (e.g. lower health literacy) (2). The Geriatric Resources for Assessment and Care of Elders (GRACE) care model was designed to address the unique challenges and unmet health needs of lower income older adults with both chronic illnesses and functional impairments.
The Goal of the Grace Model
The GRACE model is an innovative, home-based care management intervention that coordinates comprehensive, integrated primary care and social services for the target population(1, …show more content…
Moreover, the program reduced hospitalizations rates, which led to cost savings, even when accounting for program costs(4).
Limitations of the Evidence Supporting the GRACE Model
In contrast, research has not found the GRACE model to improve functional status or to reduce declines in functional status(4). Therefore, it is difficult to determine whether the model should incorporate more intensive approaches to improve functional status, or if a longer follow-up period (i.e. more than 3 years) is needed to identify changes in functional status resulting from the intervention(4).
Current or Potential Barriers to Implementing the GRACE Model
Currently, most of the services provided by the GRACE model are not reimbursable(2, 5), which is the primary barrier to the implementation of this model. More specifically, the GRACE model is only available in states where “medical home” or “advanced primary care” are being piloted, since the GRACE model can be incorporated into these pilots(5).