CLIIR Awarded R01 from the National Institute on Aging

Dr. Julia Adler-Milstein and her team at the Center for Clinical Informatics and Improvement Research were recently awarded a new $4 million R01 from the National Institute on Aging entitled Advancing Coordination of Home and Community based Services for the ADRD Population. This five-year project will leverage newly-available, nationwide Medicaid claims data that capture use of home and community based services such as respite care, home health, and adult day care. These services are critical to help enable those with Alzheimer’s disease and related dementias (ADRD) and other populations avoid long-term institutional care. Yet little is known about the entities providing these services, how they interact, and how they share information to support coordinated services – both among themselves and with traditional medical care providers. We therefore will undertake the first national-scale effort to identify the specific organizations delivering HCBS to the ADRD population, and then to identify the organizational networks - including HCBS and institutional organizations – based on which organizations care for the same individuals. Prior work has defined networks of clinical providers that resulted in widely-used measures of healthcare markets (e.g., hospital referral regions). However, the definitions do not include HCBS. Defining networks that include HCBS and serve a shared ADRD population will allow us to characterize the features of the networks (e.g., size, density of ties) in addition to evaluating outcomes for those cared for by these networks. Finally, by measuring and comparing care coordination activities, including electronic information sharing, in networks with better and worse outcomes, we can identify actionable policy and practice-based strategies that improve care for a vulnerable population.