Cross-Sectoral Partnerships Address Determinants of Health for Older Adults

Cross-sectoral partnerships between Area Agencies on Aging (AAA) and healthcare and non-healthcare organizations are an effective way of addressing determinants of health among older adults, according to a recent study published in Health Affairs.

AAAs fund and provide services for older adults to help them continue an independent life by offering transportation, meal services, and other forms of support. More than 600 of these agencies have been established under the Older Americans Comprehensive Services Amendments of 1973. AAAs partner with hospitals and health insurers to connect social services to the elderly.

Researchers examined collaborations among AAAs and social and medical organizations to determine if they significantly reduced avoidable healthcare spending among the older adult community through preventive services. A total of 368 AAAs across 1916 counties were included in the study. Risk-stratified hospital readmission rates, nursing home residents with low-care status, and total Medicare spending per beneficiary were the main measures of research while each AAA budget was analyzed to create a ratio to the total population over the age 60.

The data showed the distinction between informal and formal collaborations between AAAs and other local organizations. While informal partnerships are established through continuous collaborative work to create interconnections within a community, formal partnerships are less about coordination in the community as they are formed to achieve targeted objectives developed by that specific agency.

The results showed that on average each agency had 10.9 informal partnerships mostly with long-term care facilities and advocacy organizations. The average number of formal partnerships was 5.5 organizations. These were mostly with state health insurance assistance programs and Medicaid. The researchers found that 61.8% of agencies had programs to facilitate transitions from institutional placements and 68.2% had programs to divert patients from nursing home placement.

“As policy makers and healthcare providers consider using cross-sectoral partnerships to improve health and reduce the need for costly healthcare services, our findings have 2 implications.” the authors deduced. “First, AAAs’ partnership behavior appears to be linked to valued health outcomes for older adults, making the agencies a natural point of intervention for efforts to foster effective cross-sectoral partnerships to serve this population. Second, informal (noncontractual) and formal (contractual) partnerships may reflect different processes at the interorganizational and community levels, and therefore have different implications for service use and costs.”

References

Brewster AL, Kunkel S, Straker J, Curry LA. Cross-sectoral partnerships by area agencies on aging: associations with health care use and spending. Health Aff. 2017;37(1). doi: 10.1377/hlthaff.2017.1346.