A few months ago some of the Division of Aging team took a road trip with me to Ft. Wayne, Indiana to see firsthand the cool stuff we have been hearing about a community based organization called Aging and In Home Services. What we found was even more compelling than the stories that we had been hearing.
Area Agencies on Aging (AAA) are regionally designated providers of social services, traditionally for the aging population. A short time ago, the new director of the Ft. Wayne AAA decided that maybe they were looking at social service delivery wrong. What she saw was a group of frail, vulnerable people being asked to navigate two highly complex systems simultaneously: the health care system and the social service system. Her idea was to COMBINE the two by making social service delivery part of health care. It literally meant turning the world upside down.
The current way most aging individuals enter the social service system is when they have exhausted their resources in the health care system, which is the most expensive way to take care of people. It is also a great way to guarantee that people need to be sick before they receive help. What this AAA pitched to the insurance companies in northeast Indiana is that it might be better for these individuals to start in social services and thus decrease or even avoid much of high cost health care because their needs are already met. She even went so far as to re-brand her social workers who do in-home case management as “social practitioners” so that their status in the health care team would be more easily identifiable.
When they looked at the cost comparison, their social service programs cost $13/day on average whereas comparable health care costs are $4900/day. For example, reliable, planned transportation to dialysis is infinitely more affordable than dialysis during a hospital stay. Rather than being an add on, this AAA would like for us to think of them as the entry point for the health care continuum, helping vulnerable patients achieve outcomes that meet their values and don’t break the bank.
What if we streamlined our points of entry so that we meet individual’s needs before their environment makes them sick? What if health care and social services were integrated so that health really could start (and stay) at home? What if the least expensive intervention really could be the best one?
The world of What If is exactly where I would love all of us to find ourselves every day. What a powerful way to imagine the impossible and then make it possible.
Watch the full FIX18 talk below!