Annals of Long Term Care

IOM Releases Report Finding U.S. “Woefully” Unprepared to Care for Aging Population; AGS Chief Testifies Before Congress On Behalf of Healthcare Reforms to Ready Nation for Age Boom
The Institute of Medicine (IOM) released its long-awaited report evaluating the readiness of the nation's healthcare workforce to meet the needs of an aging society April 14. The report, “Retooling for an Aging America; Building the Health Care Workforce,” concludes that the workforce “will be woefully inadequate in its capacity to meet the large demand for health services for older adults if current patterns of care and of the training of providers continue.” It recommends sweeping changes to prevent such a crisis.

Testifying before the Senate Special Committee on Aging two days after the report’s release, AGS Board Chairman Todd Semla, PharmD, urged lawmakers to support initiatives that would address these shortcomings in the nation’s healthcare system. The initiatives, for which AGS has long advocated, parallel many outlined in the IOM report. To increase recruitment into geriatrics, adequately train all healthcare providers who care for older adults, and ensure that older people get appropriate and cost-effective care, the report recommends, among other things, that:

•public and private payers offer a “specific enhancement of reimbursement” for healthcare services to older adults provided by practitioners with a "certification of special expertise in geriatrics.”
•state and federal governments offer loan forgiveness, scholarships, and other financing incentives to professionals who specialize in geriatrics.
•Congress expand the Geriatric Academic Career Award program to support junior geriatrics faculty in other health professions in addition to medicine.
•states and the federal government increase minimum training standards for all direct care workers.
•state Medicaid programs increase pay and benefits for direct care workers, who are poorly paid and often lack basic benefits, to improve recruitment and retention of these workers.
•public, private, and community organizations provide funding and ensure adequate training for family and other informal caregivers.
•Congress and foundations "significantly increase" support for research and demonstration programs that lead to development of new models of care in areas such as prevention, long-term and palliative care, and models of care that promote the effective uses of the workforce.
•public and private payers promote and reward new models of care for older adults that are shown to be effective and efficient. This might include coverage of key services, such as care coordination, that are currently not covered but are integral to quality care and may result in both improved outcomes and savings.
•healthcare professionals and regulators consider expanding the roles and responsibilities of healthcare providers to better meet the needs of an aging population.

“Retooling for an Aging America” could be a turning point in healthcare for older adults in this country, panelists discussing the report at the AGS’s Annual Scientific Meeting in May agreed. To bring about the changes the IOM recommends and effect other needed policy changes, however, advocates of higher-quality, more cost-effective care need to build on the report’s findings, and, most important, press policymakers for change, members of the expert panel concurred.

“AGS is already working toward this goal in a variety of ways,“ said panel moderator and AGS President John Murphy, MD, citing Dr. Semla’s appearance before the Senate Special Committee on Aging, the many interviews he and others in the field have had with media covering the report, and additional AGS efforts. Among other things, more than 150 AGS members met with nearly 80 senators and representatives during the Society’s Annual Scientific Meeting in Washington, DC, to discuss the report and advocate for measures it recommends.