The above-titled phrase is commonly abbreviated as ACE. This model of patient care is promoted as one that delivers numerous benefits to the elderly. ACEs use interdisciplinary teams to offer services with geriatricians and geriatric-certified advanced practice nurses as examples. Secondly, the physical environment is manipulated to encourage safe patient self-care. Still, clinical guidelines for bedside care by healthcare professionals designed to avert patient disability and bring back the self-care lost by the acute illness. Equally, there offer advanced planning for the transition of medical care and general care. Inpatient palliative care consulting services, geriatric consult services, and home-based care services are among the other services offered by ACEs.
The ACE model avails itself to the dominant payment mechanisms: the fee-for-payment system and the shared-savings or value-based contracts. According to the Commonwealth Fund International Experts Working Group on Patients with Complex Conditions (2017), the existing payment mechanisms worsen the problems of fragmented care. Because the model reduces the length of admission by reducing medication, improving mental functions and physical mobility, the fee-for-payment payment system is preferred (Barnes et al, 2012: Palmer, 2018). Here, the logic is that the model reduces the losses attached to protracted admissions for complex patients.
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An analysis of the model reveals that its strength lies in its comprehensive patient-centered approach to healthcare. Specifically, the model has been successful in reducing readmission rates, length of hospital stays, and costs. The model depends on specialists like geriatricians. Even though statistical trends point out to an increase in the elderly constituency of the population, currently, there are not enough specialized nurses and geriatricians (Conroy & Turpin, 2016). Therefore, while statistical trends reveal an opportunity, the time-consuming nature of training specialists plus the lag of medical school curricula and training programs highlight a weakness. This development threatens the future success of this model. Therefore, while this model has registered historical success, current statistical trends indicate areas of potential opportunities, weaknesses, and threats.
Undoubtedly, this model of care has proved its efficacy and the same shall prove more significant in the future. Because of the involvement of the interdisciplinary healthcare team, patients work with several physicians. Typically, each physician is treating a different condition on the same patient, they prescribe too much medication (Conroy & Turpin, 2016). Therefore, ACEs need to improve their medication regimen. Secondly, because of the increase in the number of emergency department attendance by the elderly, there is a need for better professional collaborations between geriatricians and personnel from the emergency departments.
The federal healthcare programs, Medicare and Medicaid, provide some services relevant to ACEs but patients must first be eligible for such services. The former is a health insurance program for patients with disabilities or over 65 (Lawrence, 2015). With specific regard to acute care, it covers medications, doctors’ visits, hospital stays, and diagnostic tests. Also, it covers rehabilitation under exceptional circumstances. Here, fees are covered by taxes, additional premiums, co-payments, deductibles, and Social Security checks (Lawrence, 2015). Medicaid covers both acute and long-term care for low-income families. Private insurance is problematic because not only are premium costs high, but they also depend on the factors like the age and health status of the purchaser as well as the benefits covered by the policy (Lawrence, 2015). Furthermore, there are policies with protracted waiting periods and loopholes that cancel certain treatments. Put succinctly, it seems that the federal healthcare programs offer the best alternative for ACE cases.
References
Barnes, E., D., Palmer, M., R., Kresevic, M., D., Fortinsky, H., R., Kowal, R., Chren, M & Landefeld, C., S. (2012). Acute Care for Elders Units Produced Shorter Hospital Stays at Lower Cost While Maintaining Patients’ Functional Status. Health Affairs , 31(6). doi: https://doi.org/10.1377/hlthaff.2012.0142 .
Conroy, P., S., & Turpin, S. (2016). New horizons: urgent care for older people with frailty. Age and Aging , 45(5), pp. 577-584. doi: https://doi.org/10.1093/ageing/afw135 .
Lawrence, B. (2015, February 15). Q&A: How do you pay for long-term care? Pbs News Hour . Retrieved from https://www.pbs.org/newshour/health/paying-long-term-care .
Palmer, M., R. (2018). The Acute Care for Elders Unit Model of Care. Geriatrics , 3(3). doi: https://dx.doi.org/10.3390/geriatrics3030059 .
The Commonwealth Fund International Experts Working Group on Patients with Complex Conditions. (2017). Designing a High-Performing Health Care System for Patients with Complex Needs: Ten Recommendations for Policymakers. The Commonwealth Fund . Retrieved from https://www.commonwealthfund.org/publications/fund-reports/2017/sep/designing-high-performing-health-care-system-patients-complex .
