IU receives CMS grant to expand Aging Brain Care model

A $7.8 million Health Care Innovation Award to Indiana University from the Centers for Medicare & Medicaid Services (CMS), will expand the Aging Brain Care model developed by researcher-clinicians from the IU Center for Aging Research and the Regenstrief Institute. Based upon a successful pilot study conducted at Wishard Health Services, the new program will serve more than 2,000 Medicare beneficiaries with dementia or late-life depression who live in Marion County, Ind., evaluating the ability of the ABC program to deliver better health care to older adults.

The CMS-supported expansion of the ABC model to Wishard's 11 community health centers will be led by Regenstrief Institute investigator Malaz Boustani, M.D., MPH, associate professor of medicine at the IU School of Medicine.

"The ABC growth will improve the quality and lower the cost of care for the most vulnerable population we serve," said Dr. Boustani, who is associate director of the IU Center for Aging Research and medical director of the Healthy Aging Brain Center at Wishard.

Innovative brain care that has been demonstrated in a pilot study to reduce emergency department visits by 45 percent and hospitalizations by 54 percent, and to encourage use of medications that are not harmful to older brains, the ABC model broadens the definition of a patient to include family members who enable cognitively impaired and depressed individuals to live in the community. Physicians, nurses, social workers and other staff members work closely with both the older adult and family caregivers -- in the exam room and in the home, as well as over the phone and via email -- to deliver care to improve both brain and physical health.

Patients receiving the ABC model of care are given an initial cognitive, social and psychological needs assessment. The ABC team then helps both patient and caregivers develop a personal treatment plan that typically includes recognizing potentially harmful medications, prescribing new medications, initiating brain and physical exercise regimens, and working on reducing stress to improve daily life.

The ABC model provides individualized and integrated care through an interdisciplinary care team staffed by nurse-practitioners, social workers and care coordinator assistants. These teams work with patients, families, primary-care providers and specialists to develop patient-specific care plans, deliver evidence-based protocols, and respond to real-time monitoring and feedback, improving care and lowering cost through care management.

"We are grateful to Dr. Boustani and his team for their presence at Wishard and their thoughtful development and execution of this groundbreaking approach to care," said Lee Livin, chief financial officer for Wishard Health Services, who worked with Dr. Boustani to establish the Healthy Aging Brain Center at Wishard and will serve as co-director of this Aging Brain Care model expansion. "This is a terrific example of how Wishard's longstanding partnership with the Regenstrief Institute, widely recognized as a national model for health care innovation, directly benefits the patients we serve."

Partners in the CMS-supported project, in addition to the IU Center for Aging Research, Regenstrief and Wishard, are the Geriatrics Program of the IU School of Medicine, Indianapolis Discovery Network for Dementia, Indiana Clinical and Translational Sciences Institute, IU School of Medicine Simulation Center and the Indiana Network for Patient Care.

"The IU School of Medicine is delighted to learn of the Health Care Innovation Award to Dr. Boustani," said David Wilkes, M.D., executive associate dean for research affairs at the IU School of Medicine and the August M. Watanabe Professor of Medical Research. "This award is testament to his outstanding expertise in health care innovation and implementation science. Furthermore, this will leverage our partners in health care delivery at Wishard Hospital, IU Health and the Regenstrief Institute, amongst others. We are confident that patient care will benefit greatly due to studies supported by this award."

Over the three-year period of CMS support, the award recipients estimate that 25 jobs will be created for positions including advanced practice care coordinators, nurses, medical care coordinators' assistants, social workers and a medical director.