In an article published in the January-February 2012 issue of AgingToday, a publication of the American Society on Aging, PHI proposes developing an “advanced aide” position that could play a critical role on care teams to improve outcomes and cost efficiencies.

“Making the Most of Direct-Care Workers with a New Role on the Care Team” (pdf) explains that with delivery system reforms moving toward managed care and the Affordable Care Act‘s emphasis on testing new coordinated care models, this is an ideal moment to “engage in a thoughtful redesign of the role of the direct-care worker.”

One of the specific opportunities the authors mention is the recent request for proposals for the Center for Medicaid and Medicare Innovation “Health Care Innovation Challenge” grant.

Well Worth the Investment

The creation of an advanced aide position “would be well worth a substantial investment in training, support and compensation,” write the authors, PHI Policy Analysts Gail MacInnes and Meghan Shineman.

“Advanced aides could support health promotion, improved chronic care management and better care transitions — resulting in less institutionalization, fewer re-hospitalizations, and decreased emergency room visits.”

Employers could determine how advanced aides “could play a stronger role in a more integrated care team,” suggest the authors, who add that it is “too early to articulate a precise portable definition” of the Advanced Aide position but the time is ripe for experimentation.

Enhancing the role of direct-care workers is the intent of a bill recently introduced by Senator Robert Casey (D-PA) to establish demonstration projects that focus on care coordination and service delivery redesign for older adults with chronic illnesses, or those at risk of institutional placement.

– by Deane Beebe