Improving the lives of older Americans Helping Medicare Beneficiaries Get the Most out of Prevention Linking to the Chronic Disease Self-Management Program.

Improving the lives of older Americans

Helping Medicare Beneficiaries Get the Most out of Prevention

Linking to the Chronic Disease Self-Management Program

© 2011. National Council on AgingA nonprofit service and advocacy organization

National Council on Aging

NCOA’s MissionTo improve the lives of older Americans.

Who We Are NCOA is a non-profit service and advocacy organization based in Washington, DC.

NCOA Core Values

Social and Economic

Justice

Respect and Caring

Innovation

Integrity and Excellence


National Council on Aging

What We Do• NCOA is a national voice for older adults—especially those who are

vulnerable and disadvantaged—and the community organizations that serve them.

• NCOA brings together non-profit organizations, businesses and government to develop creative solutions that improve the lives of all older adults.

• NCOA works with thousands of organizations across the country to help seniors live independently, find jobs and benefits, improve their health, live independently and remain active in their communities


Chronic Disease Self-Management Program

• Chronic Disease Self-Management Program (CDSMP) developed in the early 1990s by the Stanford University

• This ‘gold standard’ of evidence-based disease prevention programs has been able to duplicate clinical trial results in a variety of settings, populations, and chronic conditions.

• Now used internationally in 23 countries and over 46 U.S. states, DC and Puerto Rico.

• Provides knowledge and skills for individuals to take a more active role in their own health.


CDSMP is.. A low cost or no cost tool and resource you could link

Medicare beneficiaries to that would improve their quality of life

A proven evidence-based program supported by AoA and CDC, most recently through Recovery Act grants

A strategy to help beneficiaries manage their medications and their health conditions


Chronic Disease is an Epidemic of Unparalleled Proportions More than 1.7 million Americans die of a chronic disease

each year. 80% of older adults have at least one chronic condition;

50% at least two. Greater prevalence among minority populations 95% of health care spending for older adults attributed to

chronic conditions Four chronic diseases—heart disease, cancer, stroke, and

diabetes—cause almost two-thirds of all deaths each year.


CDSMP Workshops Small group workshop of 10-16 people helps people of all

ages with chronic conditions and their caregivers:o Improve/increase healthy behaviors o Use tools and strategies to manage long-term conditionso Feel bettero Spend less days in hospitals, emergency rooms and have

fewer doctor visits Workshop topics include:

o Exercise and nutritiono Medication usageo Stress managemento Talking with your doctoro Dealing with emotions and depression


Results for Participants Workshops help participants regain control of their life and do the

things that matter to them.

People feel calmer, less worried and more confident about managing their health.

Participants report they have energy to do more and get relief

from pain, fatigue and other symptoms.

Workshops are held in AAA’s, senior centers, other community

settings• NCOA has an online version, Better Choices, Better Health

• Insurers/health plans are offering program to their patients • Grant-funded pilots in CA, HI, IA, MA, ME, NJ and OR • Now available nationwide


Where AoA Supported Workshops are Held


CDSMP Reach Chronic Disease Self-Management Programs reaching

more than 69,000 older adults


Adoption of Evidence Based Programs Supported by the Administration on Aging

Years of Growth

2001 4 communities

2003 14 communities

2006 16 states

2007 27 states

2010 46 states, DC, & Puerto Rico


Recovery Act CDSMP Grant Progress* 40,313 participants and 29,771 completers 3,669 workshops at 2,685 sites Average age 67 years; 22.3% males; 68% Whites, 20.2% African Americans; 17.6% Hispanics

58.9% more than one chronic condition • Hypertension 41.5%• Arthritis 40.3%• Diabetes 29.5%

*As of May 18, 2011


Working Together Benefits Counselors (MIPPA Grantees and Benefits Enrollment Centers at AAAs, ADRC, CILs, SHIPs and more) and CDSMP:

o Can engage in mutual referrals and cross communications – CDSMP is particularly relevant to the new provisions for a wellness visit and prevention plan for Medicare beneficiaries

Ask your state’s CDSMP coordinator to do a presentation at an in-service training for benefits counselors to talk about CDSMP

Include information about CDSMP in Medicare related presentations, outreach events, at health fairs and in written information

Inform your partners – such as Federally Qualified Health Centers –about CDSMP


Working Together.. Revise protocols for telephone contacts with consumers

and family members. Consider adding a couple of questions:

• “Do you have a long term condition such as arthritis, heart disease or diabetes that impacts your life?”

• “Are you worried or concerned you might fall? (YES/NO) • As a result of this concern, have you stopped doing some of the

things you used to do or like to do? (YES/NO)”

Refer appropriate callers to CDSMP coordinator for class schedules


Example: New Jersey Flyer

Take Control of Your HealthYou’ve chosen your Medicare Part D Plan

Now learn how to work with your doctor to get the best results through our 6-week workshop on

Chronic Disease Self Management

You will learn how to:

Determine the purpose of medications

Understand the effects of your medication

Take responsibility for medication use

Evaluate your medical treatment

Communicate with your doctors

Call now to enroll in a workshop – Name and phone #


Resources A 2011 report entitled, Enhancing Use of Clinical Preventive Services

Among Older Adults: Closing the Gap, published jointly by CDC, AoA, and AHRQ, reviews interventions to increase awareness and use of preventive services, particularly in diverse communities: http://www.cdc.gov/Features/PreventiveServices/Clinical_Preventive_Services_Closing_the_Gap_Report.pdf

For more information about the Chronic Disease Self Management Program (CDSMP) and other Evidence Based Programs for Disease and Disability Prevention: www.healthyagingprograms.org

For the CDSMP AoA-funded contact in your state:

http://aoa.gov/AoARoot/AoA_Programs/HPW/ARRA/index.aspx


PresentersMary Walsh, Senior Program AssociateNational Council on Aging, Center for Healthy [email protected](207)737-2807(207)446-7253

Abigail MorganUS Administration on Aging(202)[email protected]

Patrick Adams, Manager - Community ProgramsOffice of Elder Services, Augusta, Maine Phone: (207) [email protected]

Improving the lives of older Americans Helping Medicare Beneficiaries Get the Most out of Prevention Linking to the Chronic Disease Self-Management Program.

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