The Atlanta Regional Commission, with funding from President Obama’s health care law, wants to help Cobb seniors released from a hospital quickly recover.
The regional commission chaired by Tad Leithead is helping fund a county program, the Cobb County Care Transitions Program, that caters to seniors recently discharged from a hospital.
Twenty percent of Medicare patients who are discharged end up back within 30 days, said Mary Blumberg, manager of the health and services department at the Atlanta Regional Commission, a planning and development agency.
It’s a problem that’s only growing as the baby boomer generation continues to age and enter into retirement.
“In Georgia and the Atlanta region, and really across the nation, the demographics are changing and there are many older people, and people are living longer than they were previously,” Blumberg said.
One in 10 metro Atlanta residents is age 60 or older. That population is expected to jump to one in five by 2030.
It’s one reason the ARC decided to partner with some local governments across its 10-county region to help fund the program that is being tested in counties across the state for five years.
Cobb’s senior services department will get $12,037.
The Care Transitions Program is fully funded under the Affordable Care Act, also known as Obamacare. The ARC gets money that is passed down from the federal government to the Centers for Medicaid and Medicare. It then reimburses partnered counties for expenses.
“We are already experiencing greater numbers of aging peoples,” Blumberg said.
Proper care in the first few days after a hospital discharge is essential for sustaining long-term health, said Jessica Gill, director of the county’s senior services department, which operates a budget of about $3.4 million.
“It just overall improves quality of life,” Gill said. “When someone comes out of the hospital, they’re generally not in the best shape they can be, and this helps them to recover quicker.”
Patients who have suffered heart attacks, congestive heart failure and pneumonia see the most readmissions.
Eligible Medicare patients get help
from county staff and volunteers with home delivered meals, in-home services like laundry and cleaning, and transportation to and from doctor appointments.
“The whole goal is that this is done within the first 30 days of discharge so they don’t bounce back to the hospital,” Gill said.
WellStar Health System has partnered with the county to recommend at-risk patients for the program.
Kristyn Greifer, vice president of public health management, says planning to return home from a hospital visit must start at the hospital.
“Once you get home, you can have difficulty remembering everything you were supposed to do,” Greifer said.
WellStar employees call every Medicare patient who is discharged within 72 hours.
Greifer says the care transitions program can make a difference and she wants to see it expanded. Still, the community can do its part to ensure senior neighbors are well, Greifer said.
“As an individual in the community, if you know that you have seniors in your neighborhood, knock on their door and make sure they’re all right,” Greifer said.
Cobb helped 153 residents with its care transitions program from July 2012 through the end of June this year. Since this July, 48 residents have been helped, Gill said.
The county’s senior services department offers a program year-round that gives seniors help with meals, and transportation to eligible seniors. The program the Atlanta Regional Commission has committed $12,000 to goes specifically for patients who have left the hospital.
Gill says if the program runs out of money, the department might attempt to absorb the cost through other sources, like grants or its operating budget.