Community Aging in Place - Advancing Better Living for Elders (CAPABLE)
An Evidence-Based Practice
Description
The CAPABLE program was designed as an extension of the Advancing Better Living for Elders (ABLE) program, which improved the activities of daily living such as bathing, dressing, or walking for older patients. By making improvements to occupational therapy delivery and home modifications specific in increasing independent functional in-home goals, the aging population can sustain individual capacity in the home environment while reducing Medicaid costs.
These interventions reduce health effects of impaired physical function as well as depressive symptom management that dependent living can lead towards.
These interventions reduce health effects of impaired physical function as well as depressive symptom management that dependent living can lead towards.
Goal / Mission
CAPABLE is a 5-month structured home visit program delivered by an occupational therapist (OT), a registered nurse (RN), and a handyman to improve daily function in older adults and to lower the monthly average Medicaid expenditure and likelihood of costly healthcare services.
Impact
This study demonstrates that home visit programs can improve the daily quality of life in aging adults. Additionally, they can lead to a reduction in Medicaid expenditures via lower inpatient costs and lower long-term care costs.
Results / Accomplishments
This study used a single-arm randomized clinical trial with a comparison group (n=2,013) of individuals dually eligible for Medicaid and Medicare matched on geographic, demographic, and healthcare use baseline characteristics to the treatment group (n=204). Over the 5 month program period, participants received up to 6 OT sessions, 4 RN sessions, and $1,300 of home repair, modifications, and assistive devices. Cost components including home visit duration, travel time, mileage, frequency of meetings, visit preparation time, and care coordination were all recorded. Additionally, Medicaid claims data was obtained for both the treatment and comparison groups in order to evaluate total Medicaid expenditures.
The treatment group had a significantly lower probability (43% vs 54%) of having an expenditure for any service type (p<0.05) during the program period. Additionally, total Medicaid monthly expenditures were lower for the treatment group ($867 per month per person) than the comparison group.
The treatment group had a significantly lower probability (43% vs 54%) of having an expenditure for any service type (p<0.05) during the program period. Additionally, total Medicaid monthly expenditures were lower for the treatment group ($867 per month per person) than the comparison group.
About this Promising Practice
Organization(s)
Johns Hopkins School of Nursing
Primary Contact
Sarah Szanton, PhD, ANP, FAAN
Johns Hopkins School of Nursing
525 N Wolfe St. #424
Baltimore, MD, 21205
410-502-2605
sszanto1@jhu.edu
https://nursing.jhu.edu/faculty_research/faculty/f...
Johns Hopkins School of Nursing
525 N Wolfe St. #424
Baltimore, MD, 21205
410-502-2605
sszanto1@jhu.edu
https://nursing.jhu.edu/faculty_research/faculty/f...
Topics
Health / Older Adults
Economy / Housing & Homes
Health / Disabilities
Economy / Housing & Homes
Health / Disabilities
Organization(s)
Johns Hopkins School of Nursing
Date of publication
Mar 2018
Date of implementation
May 2012
Geographic Type
Urban
Location
Baltimore, MD
For more details
Target Audience
Adults, Older Adults