A Primer on Managed Care: Multiple Chronic Conditions

ease Self-Management Program (CDSMP) is a community-based intervention that helps indi- viduals with chronic conditions learn how to manage and improve their health, focusing on challenges that are common to older adults liv- ing with any chronic condition (e.g., pain man- agement, nutrition, exercise, medication use,

tailwinds that are accelerating opportunities for CBOs to support population health manage- ment strategies by addressing costs—in human and economic terms—of senior malnutrition. CBOs can contribute to improving older adults’ health by delivering to them consistent, qual- ity healthcare at an affordable cost. CBOs can achieve these goals

psychological effects of chronic disease, and health self-advocacy). A national study of CDSMP concluded that the program produced

by incorporating vali- dated malnutrition and recommended social risks screening tools into their care transi-

Components that address malnutrition should be embedded into chronic disease self-management programs.

measurable improvements in older adults’ health and quality of life, and also reduced healthcare expenditures (Ory et al., 2013). Incorporating course components focused on malnutrition and using the program design to explicitly address and prevent malnutrition (e.g., by targeting nutritional needs and other social determinants of health) would strengthen the value proposi- tion of CBOs seeking to partner with healthcare organizations. Tailwinds Prevail, Opportunities Abound The shift from volume-based care to value-based care is rapidly changing how older adult patients receive care. This shift will sustain the long-term

tion, disease prevention, and health promotion program assessments to effectively address the social determinants of health that contribute to and exacerbate malnutrition. Brenda Schmitthenner, M.P.A., is senior director and program officer, Successful Aging, at the West Health Institute in La Jolla, California. Andrea Morris, Ph.D., is principal investigator at the West Health Institute. Jessa K. Engelberg, Ph.D., is senior research analyst at the West Health Institute. Amy Herr, M.H.S., is director, Health Policy, at the West Health Policy Center in Washington, D.C. Cheryl Hassoldt is associate program manager, Successful Aging, at the West Health Institute.

References Agarwal, E., et al. 2013. “Malnu- trition and Poor Food Intake Are Associated with Prolonged Hospi- tal Stay, Frequent Readmissions, and Greater In-hospital Mortality: Results from the Nutrition Care Day Survey 2010.” Clinical Nutri- tion 32(5): 737–45. Cartier, Y., Fichtenberg, C., and Gottlieb, L. 2018. “Screening Tools Comparison.” swy. Retrieved October 3, 2018.

Centers for Disease Control and Prevention (CDC). 2013. The State of Aging and Health in America 2013. Atlanta, GA: U.S. Depart- ment of Health and Human Ser- vices, CDC. Econometrica, Inc., and Mathe- matica Policy Research. 2017. Eval- uation of the Community-Based Care Transitions Program (CCTP) Final Evaluation Report . Baltimore, MD: Centers for Medicare & Med- icaid Services.

Fingar, K. R., et al. 2016. All-Cause Readmissions Following Hospital Stays for Patients with Malnutri- tion, 2013 . HCUP Statistical Brief #218. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved September 6, 2018. Haynes, M., League, P., and Neault, G. 2015. “A Matter of Bal- ance: Older Adults Taking Control of Falls by Building Confidence.” Frontiers in Public Health 2: 274.

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