In today’s health care environment, improving health largely falls outside of health care facilities. Home is where health is. People with functional limitations and chronic conditions are more than four times more likely than the general population to be among the 5 percent costliest users of health services. And yet, function is rarely addressed in medical visits.
CAPABLE addresses both function and cost. CAPABLE is a program developed at the Johns Hopkins School of Nursing for low-income seniors to safely age in place. The approach teams a nurse, an occupational therapist and a handyman to address both the home environment and uses the strengths of the older adults themselves to improve safety and independence.
CAPABLE Improves Health Outcomes at Lowers Costs1
More Than 6X Return on Investment
Roughly $3,000 in program costs yielded more than $20,000 in savings in medical costs driven by reductions in both inpatient and outpatient expenditures.
Source: Ruiz, S., Snyder, L. P., Rotondo, C., Cross-Barnet, C., Colligan, E. M., & Giuriceo, K. (2017). Innovative Home Visit Models Associated With Reductions In Costs, Hospitalizations, And Emergency Department Use. Health Affairs,36(3), 425-432. doi:10.1377/hlthaff.2016.1305
Szanton, S.L., Alfonso, N., Leff, B.A. Guralnik, J., Wolff, J.L., Stockwell, I., Gitlin, L.N., Bishai, D. Medicaid cost savings of CAPABLE, a person-directed program for low-income older adults with disability In press at Journal of the American Geriatrics Society
Halved Difficulties in Function
Participants had difficulty with an average of 3.9 out of 8.0 Activities of Daily Living (ADLs) at baseline, compared to 2.0 after five months.
Reduced Symptoms of Depression
Symptoms of depression, as well as the ability to grocery shop and manage medications also improved.
The change in physical environment further motivates the participant. Addressing both the person’s stated challenges and the environment in which they live allows the person to thrive.
1 In the period 2012–15, a demonstration project enrolled 281 adults ages sixty- five and older who were dually eligible for Medicare and Medicaid and who had difficulty performing ADLs. ADLs include eating, bathing, dressing, moving around, transferring and toileting.
Testimonial - Mrs. B's Experience with CAPABLE
For more information on the Community Aging in Place—Advancing Better Living for Elders (CAPABLE) project, contact: