In this issue of the Journal of the American Geriatrics Society, Szanton and colleagues reported that an in‐home, multidisciplinary team intervention targeting risk factors for functional decline called the Community Aging in Place, Advancing Better Living for Elders (CAPABLE), was associated with significantly lower Medicaid expenditures. The focus on Medicaid costs was highly appropriate because this study enrolled only older adults who were dually eligible for Medicare and Medicaid. All study enrollees were required to have self‐reported difficulty performing at least one activity of daily living (ADL) or two instrumental ADLs (IADLs). Although this study demonstrated Medicaid cost savings, previous publications have shown that receipt of CAPABLE services is associated with clinically significant improvements over time in self‐reported performance of ADLs and IADLs and with savings in Medicare costs. Although none of these studies were randomized trials, the comparator group was constructed using rigorous matching techniques, and as the authors noted, they are conducting a randomized trial of CAPABLE in which the control group receives attention similar to that given in the CAPABLE protocol.Optimization of physical function in community‐dwelling older adults, the hallmark of the CAPABLE intervention, is highly consistent with sound geriatric care. If the evidence to date
Journal of American Geriatrics Society – Wiley
Published: Jan 1, 2018
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