GARY AND MARY WEST HEALTH INSTITUTE (EIN 26-4146730)

Program 1 [2020]
IN 2020, THE GARY AND MARY WEST INSTITUTE (REFERRED TO BELOW VARIOUSLY AS WHI, WEST HEALTH INSTITUTE OR INSTITUTE) CONTINUED TO ACTIVELY CONDUCT APPLIED MEDICAL RESEARCH, IN CONJUNCTION WITH THE HOSPITALS LISTED ON SCHEDULE A, TO GENERATE THE EVIDENCE NEEDED FOR HEALTHCARE PROVIDERS, POLICYMAKERS AND COMMUNITIES TO ADOPT ADVANCING HEALTHCARE DELIVERY MODELS THAT IMPROVE CARE AND ACCESS, WHILE REDUCING COSTS, FOR THE NATION'S FAST-GROWING, DIVERSE POPULATION OF SENIORS. THESE MEDICAL RESEARCH EFFORTS DIRECTLY SUPPORTED WHI'S MISSION OF LOWERING THE COST OF HEALTHCARE AND ENABLING SENIORS TO SUCCESSFULLY AGE IN PLACE WITH ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE.OVER THE COURSE OF 2020, WHI PURSUED MEDICAL RESEARCH IN THE FOLLOWING KEY AREAS: 1. ADVANCING SENIOR-APPROPRIATE ACUTE CARE MODELS: THE INSTITUTE CONTINUES TO RESEARCH HOW PROVIDING SENIOR-FOCUSED CARE IN AN ACUTE SETTING, SUCH AS IN THE EMERGENCY DEPARTMENT, HOME AND COMMUNITY, CAN HELP SENIORS AGE SUCCESSFULLY AND AVOID THE FUNCTIONAL DECLINE THAT MAY OFTEN ACCOMPANY HOSPITALIZATION2. ADVANCING SENIOR-APPROPRIATE CHRONIC CARE MODELS: THE INSTITUTE CONTINUES TO RESEARCH HOW TO IMPROVE CARE FOR FRAIL, MEDICALLY COMPLEX SENIORS WHILE PRESERVING THEIR FUNCTION AND ALLOWING THEM TO REMAIN IN THEIR HOMES IN ACCORDANCE WITH THEIR WISHES. IN PARTICULAR, STUDYING THESE MODELS IN THE CONTEXT OF PACE (THE FEDERALLY-ESTABLISHED PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY) A WHOLE-PERSON, VALUE-BASED MODEL OF CARE, WAS AN AREA OF FOCUS.3. SENIOR-FRIENDLY TELEHEALTH MODELS: THE CORONAVIRUS PANDEMIC IN 2020 WAS A TIPPING POINT YEAR FOR TELEHEALTH, AND THE INSTITUTE CONDUCTED AND DEMONSTRATED SEVERAL RESEARCH EFFORTS TO DETERMINE HOW TELEHEALTH, DONE CORRECTLY, CAN ENABLE BETTER CARE EXPERIENCE AND OUTCOMES FOR SENIORS, BOTH DURING A PANDEMIC AND IN MORE NORMAL TIMES.4. ADDITIONAL AREAS: OTHER RESEARCH PROJECTS PURSUED WITH HOSPITAL AND HEALTHCARE COLLABORATORS FOCUSED ON ORAL HEALTH FOR SENIORS AND UNDERSTANDING THE IMPACT AND RISK FACTORS ASSOCIATED WITH COVID-19. THESE RESEARCH PROGRAMS ARE DESCRIBED IN FURTHER DETAIL BELOW.SENIOR-APPROPRIATE ACUTE CARE IN 2020, THE INSTITUTE CONTINUED AND EXPANDED ITS RESEARCH ACTIVITIES WITH HOSPITALS, HEALTHCARE SYSTEMS, AND OTHER KEY STAKEHOLDERS TO ADDRESS BETTER RESPONSES TO UNPLANNED ACUTE CARE OF SENIOR AMERICANS. UNPLANNED ACUTE CARE FUNDAMENTALLY DRIVES THE MAJORITY OF COST FOR VULNERABLE SENIORS AND RESULTS IN DEBILITATION AND FUNCTIONAL DECLINE AFTER INPATIENT HOSPITAL STAYS. TO ADDRESS THESE FACTORS, THE INSTITUTE CONDUCTED RESEARCH EFFORTS TO IDENTIFY MORE PROACTIVE AND OPPORTUNISTIC CARE THAT IS DELIVERED IN PLACE, WHENEVER POSSIBLE, AND TO ADVANCE HOME AND COMMUNITY-BASED ACUTE CARE ALTERNATIVES. THE RESEARCH OBJECTIVES WERE TO CONTINUE ADVANCING INNOVATIVE, PERSON-CENTERED, SCALABLE, AND SUSTAINABLE MODELS FOR ACUTE CARE OF SENIORS IN THE HOSPITAL EMERGENCY DEPARTMENT, HOME AND COMMUNITY.RESEARCH PROJECTS:GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE (GEDC)THE INSTITUTE HAS FORMED, WITH MAJOR HEALTH SYSTEMS INCLUDING UNIVERSITY OF NORTH CAROLINA AND MOUNT SINAI IN NEW YORK, THE GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE (GEDC), WHICH NOW INCLUDES EXPERT GERIATRIC EMERGENCY DEPARTMENT (GED) CLINICIANS FROM OVER 40 MEMBER EDS/HEALTH SYSTEMS TO PROVIDE RESEARCH, EDUCATION, AND TRAINING FOR OTHER HEALTHCARE PROVIDERS. GEDC MEMBERS' IMPLEMENTATION RESEARCH HAS ALSO PROVIDED EARLY EVIDENCE THAT GED GUIDELINE-BASED CARE IMPROVES PATIENT OUTCOMES AND IS COST EFFECTIVE, DEMONSTRATING THE VALUE OF GEDS TO PATIENTS, HOSPITALS, PAYORS, AND THE PUBLIC AT-LARGE.IN DIRECT RESPONSE TO THE GLOBAL PANDEMIC, THE GEDC ADAPTED THEIR EDUCATIONAL AND TRAINING OFFERINGS TO A WEB-BASED PLATFORM TO ACCOMMODATE VIRTUAL AUDIENCES; CONVENED SUBJECT MATTER EXPERTS FOR MONTHLY WEBINARS; PUBLISHED AND DISSEMINATED BEST PRACTICES; DEVELOPED A COVID-19 TOOLKIT; AND ESTABLISHED AN ONLINE RESOURCE LIBRARY WHICH FEATURES THREE TOOLKITS ON IMPLEMENTING DISTINCT GED-SPECIFIC QUALITY IMPROVEMENT INITIATIVES (DEMENTIA, DELIRIUM, AND FALLS/MOBILITY) THAT WERE CO-DEVELOPED BY GEDC AND WHI. DESPITE THE ONGOING PUBLIC HEALTH CRISIS, THE GEDC FACILITATED 17 EDUCATIONAL AND TRAINING EVENTS IN 2020, REACHING OVER 1,600 PARTICIPANTS (CLINICIANS AND HOSPITAL ADMINISTRATORS) FROM 15 COUNTRIES. GEDC ALSO CONTINUED OFFERING ITS SIGNATURE GED BOOTCAMPS IN DURHAM, NC WHICH INCLUDED TEAMS FROM TEN DIFFERENT VETERAN AFFAIRS (VA) HOSPITALS FROM AROUND THE UNITED STATES IN FEBRUARY 2020 AS WELL AS VIRTUAL BOOTCAMP SESSIONS FOR SAN DIEGO COUNTY'S 18 EDS. THE GEDC AND WHI ALSO JOINTLY LAUNCHED A HEALTHCARE SYSTEMS ROUNDTABLE TO LEVERAGE INSIGHTS FROM EIGHT ALREADY ACCREDITED HEALTH SYSTEMS (REPRESENTING 126 EDS) TO DEVELOP IMPLEMENTATION RESOURCES (E.G., GUIDE, TOOLKITS) FOR PROSPECTIVE HEALTH SYSTEMS WANTING TO BECOME ACCREDITED.ADDITIONALLY, GEDC RESEARCHERS DEMONSTRATED THAT A GED NURSE INTERVENTION WAS ASSOCIATED WITH REDUCED RISK OF HOSPITAL ADMISSION AT BOTH INITIAL ED VISIT AND 30 DAYS POST-ENCOUNTER AND THAT A GED PROGRAM INCLUDING SPECIALIZED NURSE OR SOCIAL WORKER CONSULTATION WAS ASSOCIATED WITH SIGNIFICANT REDUCTIONS IN READMISSIONS AND IN TOTAL MEDICARE EXPENDITURES AT 30- AND 60-DAYS POST-ED VISITS. S. THESE RESULTS WERE PRESENTED AT NATIONAL CONFERENCES AND PUBLISHED IN SCIENTIFIC JOURNALS.THE GEDC HAS EXTENDED THE PILOT PHASE OF THE NATIONAL RESEARCH DATA WAREHOUSE TO ENCOMPASS HOSPITAL AND PATIENT-LEVEL DATA FOR OVER 280,000 UNIQUE ED ENCOUNTERS ACROSS 12 EMERGENCY DEPARTMENTS, WITH DATA TRANSFER PENDING FROM TWO MORE SITES. WHI IS SEEKING DATA FROM AN ADDITIONAL 20 EDS IN 2021 AND WILL EXPAND UPON PRELIMINARY ANALYSES SUMMARIZING PATIENT DEMOGRAPHICS AND KEY ENCOUNTER AND DIAGNOSES INFORMATION. GERIATRIC EMERGENCY DEPARTMENT ACCREDITATION (GEDA) PROGRAMIN 2018, THE INSTITUTE COMMENCED AN EFFORT WITH THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS TO ADVANCE THE GEDA PROGRAM, WHICH EXCEEDED ITS PRIMARY GOAL TO ACCREDIT AN ADDITIONAL 135 EDS IN 2020 DESPITE THE EFFECTS OF OF COVID-19. BY THE END OF 2020, OVER 200 EDS WERE FULLY ACCREDITED AND THERE ARE NOW GEDS IN OVER 170 CITIES AND TOWNS ACROSS 36 STATES. IN 2020, APPROXIMATELY 2.2 MILLION (OR APPROXIMATELY ONE IN TEN) OLDER ADULT ED VISITS IN THE US WERE MADE AT A HOSPITAL WITH AN ACCREDITED GED. DEMONSTRATING INTEREST FROM HEALTH SYSTEMS IN ACCREDITATION, 24 HEALTH SYSTEMS HAD MULTIPLE EDS APPLY FOR ACCREDITATION IN 2020, INCLUDING THE VETERANS HEALTH ADMINISTRATION (VHA) SYSTEM AND SHARP HEALTHCARE AND SCRIPPS HEALTH AS PART OF THE SAN DIEGO COUNTY SENIOR EMERGENCY CARE INITIATIVE. WHI, THE JOHN A. HARTFORD FOUNDATION AND THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS ARE SEEKING TO EXPAND THE GEDA PROGRAM THROUGH A HEALTH SYSTEMS APPROACH.SAN DIEGO COUNTY GERIATRIC EMERGENCY CARE INITIATIVETHE INSTITUTE, BASED IN SAN DIEGO COUNTY, CALIFORNIA, IS SEEKING TO HAVE 18 HOSPITALS IN SAN DIEGO COUNTY CERTIFIED AS GEDS THUS RENDERING THE COUNTY THE FIRST IN THE NATION TO HAVE ALL OF ITS EMERGENCY DEPARTMENTS ACCREDITED AS SENIOR-FRIENDLY. THE INSTITUTE, TOGETHER WITH THE GEDC AND UNIVERSITY OF CALIFORNIA SAN DIEGO, CONDUCTED A VIRTUAL TRAINING SESSION AND TWO QUALITY IMPROVEMENT IMPLEMENTATION WEBINARS FOR THE SAN DIEGO COUNTY EDS. SO FAR, TEN SITES HAVE BEEN ACCREDITED BY ACEP AND THE REMAINING EIGHT APPLICATIONS ARE UNDER REVIEW. WHI SEEKS TO TAKE THE LEARNING FROM THE SAN DIEGO COUNTY GED INITIATIVE TO COMMENCE SIMILAR EFFORTS THROUGHOUT CALIFORNIA.DARTMOUTH-HITCHCOCK EXPANSION OF GEDS TO RURAL AREAS (VIA TELEHEALTH)WHI PURSUED RESEARCH WITH THE DARTMOUTH-HITCHCOCK (D-H) HEALTH SYSTEM TO CREATE AND EVALUATE A NOVEL RURAL HUB-AND-SPOKE TELEHEALTH MODEL AND TRAINING SESSIONS. D-H HAS IMPLEMENTED NEW AND REVISED GERIATRIC ED WORKFLOWS AND PROTOCOLS, CONDUCTED THEIR FIRST GED PATIENT CONSULTATION, AND APPLIED FOR ED ACCREDITATION. VETERANS HEALTH ADMINISTRATION (VHA) GERIATRIC EMERGENCY DEPARTMENT SCALE AND SPREADTHE INSTITUTE WORKED TO IMPLEMENT AND SCALE GEDS THROUGHOUT HOSPITALS IN THE ENTIRE VHA SYSTEM. IN 2020, THE INSTITUTE SUPPORTED TRAINING, QUALITY IMPROVEMENT AND ACCREDITATION ACTIVITIES FOR 20 EDS (18% OF ALL VHA EDS). AS OF DECEMBER 2020, 17 EDS HAD APPLIED FOR ACCREDITATION AND THREE SITES ANTICIPATE APPLYING IN EARLY 2021. WHI SEEKS TO INCLUDE THE MAJORITY OF EDS IN THE VHA HEALTH SYSTEM IN ITS ACCREDITATION EFFORTS, WITH AN ULTIMATE GOAL OF ESTABLISHING A NATIONAL GED OFFICE WITHIN THE VHA.
Geographies
Not indicated
Dates
Jan 1, 2020 – Dec 31, 2020
Source
990
No causes provided
No populations provided
–
$16.7M
Program 2 [2020]
THE RISING COST OF HEALTHCARE IS A GROWING ECONOMIC AND PUBLIC HEALTH CRISIS THAT HURTS THE U.S. ECONOMY, THREATENS INDIVIDUAL FINANCIAL SECURITY, COMPROMISES CARE, AND REDUCES PATIENT ACCESS. THE COVID-19 PANDEMIC LAID BARE VULNERABILITIES IN OUR HEALTHCARE PAYMENT SYSTEM, SHINING LIGHT ON THE NEED TO LOWER COSTS AND IMPROVE ACCESS TO NEEDED CARE. IT IS ESSENTIAL TO NOTE THAT MANY ERRONEOUSLY ASSUME THAT DUE TO MEDICARE, OLDER ADULTS ARE INSULATED FROM THE TOXIC EFFECTS OF HIGH HEALTHCARE COSTS, BUT THE TRUTH IS THAT MANY SENIORS ARE HARD-HIT BY THE OUT-OF-POCKET BURDEN OF BOTH DRUG AND OTHER HEALTH COSTS. RAISE AWARENESS OF SPENDING CRISIS AND URGENCYTO FOCUS THE ATTENTION OF POLICYMAKERS, ADMINISTRATORS, THE BUSINESS COMMUNITY, AND THE GENERAL PUBLIC ON THE HEALTHCARE CRISIS, THE GARY AND MARY WEST HEALTH INSTITUTE (WHI OR WEST HEALTH INSTITUTE), IN CONJUNCTION WITH THE WEST HEALTH POLICY CENTER (WHPC), RELEASED SEVEN HIGHLY SUCCESSFUL NATIONAL POLLS IN PARTNERSHIP WITH GALLUP. THESE POLLS EXPOSED THE REALITY THAT AMERICANS' CONCERNS ABOUT THE COST OF CARE HAVE ONLY INCREASED AS A RESULT OF THE PANDEMIC. MOREOVER, NEARLY NINE IN TEN U.S. ADULTS ARE CONCERNED THAT THE PHARMACEUTICAL INDUSTRY WILL LEVERAGE THE COVID-19 PANDEMIC TO RAISE DRUG PRICES. ADDITIONAL PUBLIC AWARENESS ACTIVITIES IN 2020 INCLUDED A NATIONAL WEBINAR ON "WHY AMERICANS ARE SO WORRIED ABOUT RISING HEALTHCARE COSTS AND WHAT CAN BE DONE ABOUT IT" IN PARTNERSHIP WITH GALLUP, AS WELL AS A MEDIA FELLOWSHIP FOR JOURNALISTS COVERING THE HEALTH COST CRISIS. DEVELOP ACTIONABLE POLICIES TO LOWER DRUG COSTSSTRATEGIES TO REDUCE THE RISING COST OF PHARMACEUTICALS WERE A KEY COMPONENT OF WORK TO LOWER HEALTHCARE SPENDING. IN PARTICULAR, DEMONSTRATING PUBLIC SUPPORT FOR AND A POLICY STRATEGY TO EMPOWER CMS (THE SINGLE LARGEST PURCHASER OF HEALTHCARE IN THE US) TO NEGOTIATE DRUG PRICES FOR MEDICARE IS A KEY PRIORITY. THE AMERICAN BUSINESS COMMUNITY IS A KEY STAKEHOLDER THAT IS IMPORTANT IN ADDING MOMENTUM TO DRIVING LOWER DRUG PRICES. AS SUCH, WHI HAS CONTINUED WORK WITH BUSINESS GROUPS ON DRUG COST ISSUES, INCLUDING BUILDING A COALITION OF BOTH LARGE AND SMALL COMPANIES THAT ARE SHARING THE BURDEN PLACED ON BOTH EMPLOYERS AND EMPLOYEES BY HIGH HEALTH CARE AND DRUG COSTS. DEVELOP ACTIONABLE POLICIES TO REDUCE VOLUME INCENTIVES IN FEE-FOR-SERVICEVALUE-BASED CARE (VBC)WHICH INCORPORATES RISK FOR BOTH HEALTH AND SPENDING OUTCOMES INTO PAYMENT RATESHAS THE POTENTIAL TO REDUCE MANY OF THE VOLUME-BASED FINANCIAL INCENTIVES THAT ARE DRIVING UP PER-CAPITA HEALTHCARE COSTS. A PARTNERSHIP CONSISTING OF THE INSTITUTE, THE WEST HEALTH POLICY CENTER, AND THE DUKE-MARGOLIS CENTER FOR HEALTH POLICY HAS RELEASED NATIONAL AND STATE ROADMAPS IN 2020 WITH RECOMMENDATIONS FOR POLICYMAKERS ON WAYS TO ACCELERATE THE ADOPTION OF VBC PAYMENT MODELS. THIS WORK INFORMED THE DESIGN AND LAUNCH OF A THREE-YEAR COLLABORATION WITH THE DUKE-MARGOLIS TEAM TO TURN THESE POLICY RECOMMENDATIONS INTO ON-THE-GROUND ACTIONPRODUCING A HIGH-PROFILE WEBINAR IN 2020 TO EXAMINE THE ADVANTAGES THAT VBC OFFERS IN THE COVID-19 ENVIRONMENT, SPOTLIGHTING THE GARY AND MARY WEST PACE. COST OF CARE - PREPARING FOR OPPORTUNITIES TO EFFECT CHANGE:THE CONFLUENCE OF AN ELECTION YEAR COMING DURING A PERIOD WHEN HEALTH CARE HAS (RE)EMERGED AS ONE OF THE TOP ISSUES IN PUBLIC, SOCIAL, ECONOMIC, AND POLITICAL DISCOURSE HAS PRESENTED AN IMPORTANT OPPORTUNITY FOR WHI TO LEVERAGE ITS UNIQUE STRUCTURE OF HAVING BOTH MEDICAL RESEARCH AND POLICY EXPERTISE TO CATALYZE CHANGE FOR HEALTH COSTS AT A NATIONAL LEVEL AT WHAT IS POTENTIALLY A WATERSHED MOMENT FOR THE COST OF CARE. BEGINNING IN MID-2020, THE INSTITUTE, IN CLOSE COORDINATION WITH THE WEST HEALTH POLICY CENTER, ADVANCED A NUMBER OF COORDINATED WORKSTREAMS DESIGNED TO LEVERAGE WEST HEALTH INSTITUTE'S EXPERTISE AND RESOURCES TO PROVIDE POLICYMAKERS WITH THE TECHNICAL INFORMATION AND PUBLIC OPINION POLLING NECESSARY TO PRIORITIZE LOWERING THE COST OF CARE. THESE WORKSTREAMS ARE FOCUSED NOT ONLY ON NEAR-TERM ACTIVITIES SURROUNDING THE 2020 ELECTIONS AND THE INITIAL WORK OF THE EXECUTIVE AND LEGISLATIVE BRANCHES BUT ALSO CONTEMPLATE MID-TERM (2022) ELECTIONS AND THE IMPORTANT WORK TO BE DONE OVER THE NEXT SEVERAL YEARS. DRIVE INSIGHTS THAT EMPOWER LIKE-MINDED STAKEHOLDERS GARY AND MARY WEST HEALTH INSTITUTE IS NOT ALONE IN ITS MISSION TO REDUCE THE COST OF HEALTH CARE AT BOTH AN INDIVIDUAL AND SOCIETAL LEVEL. IN ORDER TO BUILD MOMENTUM DURING THIS CRITICAL PERIOD, WHI HAS SUPPORTED SEVERAL INITIATIVES DESIGNED TO PROVIDE OTHER LIKE-MINDED CO-TRAVELERS INCLUDING CURRENT/FUTURE LEGISLATIVE AND ADMINISTRATIVE POLICYMAKERS AND REGULATORS WITH NEW INFORMATION AND INSIGHTS THAT CAN BE USED TO DETERMINE OPTIMAL PATHS FORWARD IN PRESSING FOR HEALTHCARE COST REFORM. TO THIS END WHI ENGAGED A SELECT GROUP OF INDIVIDUALS AND ORGANIZATIONS TO ASSIST WITH A NUMBER OF ACTIVITIES INCLUDING: *STATE-LEVEL SURVEYS FOR 2020 AND 2022 RACES ON HEALTHCARE PRIORITIES IN VOTING *OFFENSIVE AND DEFENSIVE MESSAGE TESTING ON PUBLIC OPTION AND BROADER HEALTH COVERAGE REFORMS *POLLING ON PUBLIC EXPERIENCE AND SENTIMENT (ALSO USED GALLUP INC. FOR THIS WORK)THE IMPORTANT INSIGHTS DISTILLED FROM THE ABOVE ACTIVITIES HAVE BEEN PACKAGED AND USED FOR TARGETED DISSEMINATION OF KEY MESSAGES TO POLICY INFLUENCERS AND AS WELL AS TECHNICAL ASSISTANCE INCLUDING INVITATION-ONLY BRIEFINGS TO KEY STAKEHOLDERS. PERFORM RESEARCH TO SUPPORT EVIDENCE-BASED POLICYBE IT MODELING THE EXPECTED FINANCIAL IMPACT CHANGES TO POLICY, DEFINING THE EXACT CONTOURS OF AN ISSUE FOR WHICH A POLICY FIX IS NEEDED, OR ASSESSING FEASIBILITY OF A SUITE OF VARYING POLICY SCENARIOS, RESEARCH IS A CORNERSTONE OF SOUND POLICYMAKING. TO INFORM AND EMPOWER CURRENT AND NEAR-TERM FUTURE POLICIES THAT ARE (OR WILL LIKELY BE) "ON THE TABLE AND THAT ARE WITH THE GRAIN OF HEALTHCARE COST REDUCTION, OVER THE SECOND HALF OF THE 2020 WHI (AND WHPC) LEVERAGED THE RESEARCH EXPERTISE OF SEVERAL EXTERNAL PARTIES. KEY ACTIVITIES IN THIS WORKSTREAM HAVE INCLUDED: *MODELING KEY COMPONENTS OF PUBLIC OPTION AND MEDICARE ADVANTAGE IMPROVEMENTS *DEVELOPING CBO-STYLE SCORES AND PROCEDURAL MEMOS TO INFORM POLICYMAKERS *ASSESSING CAPITALIZED DRUG MANUFACTURING COSTS (TO COUNTER REBUTTALS FROM PHARMA THAT PRICE REDUCTIONS EQUATE TO REDUCED INNOVATION)SIMILAR TO OPINION POLLING INSIGHTS, OUR RESEARCH HAS BEEN DISTRIBUTED TO A NETWORK OF STAKEHOLDERS FOR WHOM HEALTH COST CONTAINMENT IS A FOCUS (OR PARTIAL FOCUS- OFTEN COST CONTAINMENT TRAVELS ALONG WITH HEALTH ACCESS ISSUES). BY INTENTION, MANY OF THE EXPERTS WE HAVE ENGAGED TO DO THIS WORK ARE THEMSELVES IMPORTANT CONDUITS TO POLICYMAKERS IN A POSITION TO USE THIS RESEARCH. AMPLIFY THE NATIONAL CONVERSATION ABOUT THE NEED TO ACT NOWLIKE OUR WORK AROUND RAISING AWARENESS OF THE SPENDING CRISIS BUT WITH A MORE TIME-LIMITED FOCUS, OVER THE LATTER HALF OF THE YEAR WHI ENGAGED IN EFFORTS TO INFORM BOTH THE PUBLIC AS WELL AS DECISIONMAKERS ABOUT THE NEED TO SEIZE CURRENT OPPORTUNITIES TO TAKE ACTION. WHI ADVANCED A NUMBER OF CAMPAIGNS DESIGNED TO CATALYZE ACTION AT BOTH THE STATE AND NATIONAL LEVEL. SOME NOTABLE EXAMPLES INCLUDED: *A DIGITAL MEDIA CAMPAIGN IN KEY STATES INCLUDING ARIZONA, COLORADO, GEORGIA, IOWA, MAINE, MONTANA, AND NORTH CAROLINA USING BOTH TWITTER (2.8 MILLION IMPRESSIONS) AND FACEBOOK (1.9 MILLION IMPRESSIONS) TO SHARE MESSAGES AROUND THE ISSUE OF HEATH COSTS AND THE NEED FOR CHANGE AT STATE AND FEDERAL LEVELS *A TELE-TOWN HALL FEATURING MICHIGAN GOVERNOR GRETCHEN WHITMER ON WHAT CAN BE DONE ABOUT THE DEVASTING IMPACTS OF INACCESSIBLE/COSTLY CARE. THIS EVENT HAD OVER 19,000 ACTIVE PARTICIPANTS *EXPLAINER ANIMATIONS ON THE HIGH COST OF DRUGS AND HEALTHCARE CONSOLIDATION *TELE-TOWN HALLS FEATURING CONSUMERS WITH COMPELLING STORIES RELATED TO THE HIGH COST OF PRESCRIPTION DRUGS (REACHING OVER 20,000 TARGETS)
Geographies
Not indicated
Dates
Jan 1, 2020 – Dec 31, 2020
Source
990
No causes provided
No populations provided
–
$311.7K
Geriatric Emergency Department Research
OVER THE COURSE OF 2022, THE GARY AND MARY WEST INSTITUTE (REFERRED TO BELOW VARIOUSLY AS WHI, WEST HEALTH INSTITUTE, OR INSTITUTE) CONTINUED TO ACTIVELY CONDUCT APPLIED MEDICAL RESEARCH, IN CONJUNCTION WITH THE HOSPITALS LISTED ON SCHEDULE A, WITH THE OBJECTIVE OF CONTRIBUTING TO THE BODY OF CLINICAL, SCIENTIFIC, AND HEALTH KNOWLEDGE THAT CAN ULTIMATELY BENEFIT OLDER ADULTS IN AMERICA. OUR RESEARCH METHODOLOGIES ENCOMPASS A VARIETY OF REAL-WORLD DATA COLLECTION AND ANALYSIS TECHNIQUES, AND IN MANY CASES, WE IMPLEMENT PROGRAMS AND STRUCTURES (E.G., STANDARDIZED CARE MODELS, DATA DASHBOARDS, ETC.) THAT ALLOW US TO COLLECT SYSTEMATIZED RESEARCH INFORMATION WHERE LITTLE PREVIOUSLY EXISTED. THESE MEDICAL RESEARCH EFFORTS DIRECTLY SUPPORTED WHI'S MISSION OF LOWERING THE COST OF HEALTHCARE AND ENABLING SENIORS TO SUCCESSFULLY AGE IN PLACE WITH ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE. OUR MAJOR WORKSTREAMS FOR 2022 BROADLY FIT INTO THE AREAS OF (SENIOR APPROPRIATE) ACUTE CARE RESEARCH, CHRONIC CARE RESEARCH, AND TELEHEALTH RESEARCH AND ARE DESCRIBED BELOW. SENIOR-APPROPRIATE ACUTE CARE RESEARCH IN 2022, THE INSTITUTE CONTINUED TO EXPAND ITS RESEARCH PORTFOLIO AND GROW THE BODY OF EVIDENCE FOR NEW STRATEGIES IN ACUTE CARE. UNPLANNED (ACUTE) NEEDS REMAIN THE PRIMARY DRIVER OF COSTS FOR THE NATION'S VULNERABLE OLDER ADULTS, AS WELL AS LEADING TO LASTING DETRIMENTAL EFFECTS (E.G., POST-VISIT DEBILITATION AND FUNCTIONAL DECLINE). SUCCESS IN THIS AREA IS ESSENTIAL TO ACHIEVING BETTER, MORE AFFORDABLE OUTCOMES FOR OLDER ADULTS. ACUTE CARE RESEARCH AREA: GERIATRIC EMERGENCY DEPARTMENTS (GEDS):GED HEATMAP: DEVELOPING TOOLS TO INCREASE SCOPE OF COLLABORATIVE WORK WITH STAKEHOLDERS GERIATRIC EMERGENCY DEPARTMENTS ARE A RESOURCE THAT, IDEALLY, SHOULD EXPAND TO MEET THE NEEDS OF AMERICA'S STEADILY GROWING OLDER ADULT POPULATION. IN ORDER TO CHART THE SPREAD OF ACCREDITED GERIATRIC EMERGENCY DEPARTMENTS AT US HOSPITALS, THE INSTITUTE IS INTERNALLY DEVELOPING AN INSTRUMENT THAT QUANTIFIES WHERE ACCESS IS NEEDED AND FOCUSES ON HIGH-RISK SITES. THIS TOOL CONSISTS OF ELIGIBLE ACUTE CARE FACILITIES, POPULATION- LEVEL DATA AND EXISTING ACCREDITED SITES. THIS INTERACTIVE "HEATMAP" IS BEING ENGINEERED TO EXAMINE THE DISTRIBUTION OF GED'S ACROSS THE COUNTRY AND ASSESS THE NEED FOR ADOPTION. FOR COLLABORATORS, THIS HEATMAP CAN TARGET WHICH AREAS INDICATE POTENTIAL FUTURE SITES FOR ACCREDITATION. FOR RESEARCHERS, THIS EVIDENCE-BASED TOOL CAN HELP WITH STUDYING SCALABILITY. GED DASHBOARD: GIVING GEDS A TOOL TO TRACK PROGRESS:GEDS NEED DATA TO DRIVE THEIR OWN DECISION-MAKING AND INFORM ON-GOING PROCESS IMPROVEMENTS. WHI HAS DEVELOPED AND HOSTS A DASHBOARD FOR PARTICIPATING GEDS THAT ENABLES THEM TO TRACK THEIR PROGRESS OVER TIME AGAINST THEIR OWN GOALS. THE INSTITUTE HAS COLLECTED AGGREGATE LEVEL DATA FROM PILOTING EMERGENCY DEPARTMENTS AND BEGUN TESTING THE PLATFORM TO DETERMINE USABILITY AND ALIGNMENT TO STRATEGIC GOALS FOR EMERGENCY DEPARTMENT LEADERS.EXAMINING THE DIFFERENCES IN THE COST OF CARE FOR GED PATIENTS:THE UNIVERSITY OF CALIFORNIA SAN DIEGO (UCSD) HOSPITAL HEALTH COLLABORATION HAS PROVEN TO BE A SUCCESSFUL PARTNERSHIP AS THEY PAVED THE WAY FOR ALL UC HEALTH SYSTEMS IN CALIFORNIA TO ACHIEVE GED ACCREDITATION WITH WHI SUPPORT. THIS YEAR, TO ILLUSTRATE THE VALUE OF GEDS TO INTERNAL AND EXTERNAL STAKEHOLDERS, THE INSTITUTE COLLABORATED WITH UCSD IN CONDUCTING A COSTING STUDY TO ASSESS DIFFERENCES IN THE COST OF CARE FOR PATIENTS WHO RECEIVED GED SERVICES VERSUS THOSE WHO DID NOT RECEIVE GED SERVICES. ONCE THE STUDY WAS FINALIZED, IT WAS PRESENTED AT THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS (ACEP) SCIENTIFIC ASSEMBLY IN OCTOBER 2022. THE COSTING STUDY INFORMED THE DEVELOPMENT OF A PLAN TO ADDRESS LONG-TERM SUSTAINABILITY OF THE GED PROGRAM AT UCSD AND AS A MODEL FOR OTHER GEDS. THE INSTITUTE PROVIDED ADVISORY SUPPORT TO UCSD REGARDING THE ANALYSIS, SUPPORTED THE INTERPRETATION OF RESULTS, AND CO-AUTHORSHIP OF PAPER. SHARING LESSONS LEARNED AND A GLANCE INTO RURAL HEALTHCARE:THIS YEAR THE INSTITUTE WORKED CLOSELY WITH DARTMOUTH HITCHCOCK MEDICAL CENTER HOSPITAL (DHMC) TO EVALUATE AND DISSEMINATE LEARNINGS FROM THEIR GED IMPLEMENTATION. ADDITIONALLY, WHI ORGANIZED VIRTUAL SITE VISITS WITH CRITICAL ACCESS HOSPITALS AND LEARNED ABOUT THE BARRIERS IN CARE PROVISION FOR THEIR OLDER ADULT POPULATIONS. WITH THIS AND ADDITIONAL FEEDBACK FROM DHMC, WE CODIFIED AND DOCUMENTED GUIDELINES FOR USE OF TELEHEALTH IN THE ED FOR RURAL HOSPITALS. TWO PAPERS WERE AUTHORED JOINTLY BY DHMC AND WHI ON ED TRANSITIONS OF CARE AND PATIENT EXPERIENCE, ILLUSTRATING THE CARE PROVIDED TO OLDER ADULT PATIENTS IN RURAL NEW HAMPSHIRE BY DHMC. WHI AND DHMC ALSO CREATED A 'LESSONS LEARNED' BRIEF AND A BUSINESS CASE STUDY THAT INCORPORATES INFORMATION AND RECOMMENDATIONS ABOUT SPREADING GED ACCREDITATION IN RURAL AREA HOSPITALS BASED ON THE DHMC EXPERIENCE AND APPROACH. ENGAGING WITH MULTIDISCIPLINARY RESEARCH STAKEHOLDERS:WHI DEVELOPED, HOSTED, AND MANAGED A RESEARCH DATA WAREHOUSE (RDW) TO ACT AS A MULTI-SITE GED DATA DEPOSITORY. THE RDW CONTAINED LIMITED DATASETS FROM 17 DIFFERENT GED HOSPITALS TO FACILITATE MULTISITE RESEARCH ON GERIATRIC EMERGENCY MEDICINE. SEVERAL RESEARCH PLANS TO USE THIS DATA WERE DEVELOPED WITH EXTERNAL COLLABORATORS. WHI ALSO REVIEWED RESEARCH FUNDING APPLICATIONS FOR USE OF THE RDW THROUGH PILOT GRANTS.WHI REVIEWED SEVERAL DRAFT MANUSCRIPTS DEVELOPED BY YALE SCHOOL OF MEDICINE AND GEDC SUBCONTRACTORS THAT ASSESSED OUTCOMES OF OLDER ADULTS IN EDS. ADDITIONALLY, THE INSTITUTE DEVELOPED A LOGIC MODEL FOR GEDS WITH SUPPORT OF GEDC EXPERTS FOR DISSEMINATION TO THE BROADER RESEARCH COMMUNITY. THE LOGIC MODELS PROVIDE A VISUAL FRAMEWORK OF THE PROGRAM FOR THOSE SEEKING TO IDENTIFY POTENTIAL RESEARCH QUESTIONS AND LEVERAGE POINTS FOR INTERVENTION. WHI PRESENTED AT THE ACEP ANNUAL CONFERENCE REGARDING THE RESEARCH DATA WAREHOUSE. CAPTURING SITES ACROSS SAN DIEGO COUNTY (ACEP):IN COLLABORATION WITH WHI, THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS (ACEP) SUCCESSFULLY ORCHESTRATED A COUNTY-WIDE ACCREDITATION PROGRAM RESULTING IN ALL HOSPITAL SITES IN SAN DIEGO TO OBTAIN BETWEEN LEVEL 1, 2, OR 3 GED ACCREDITATION. WHI SAT IN ON WORKING GROUPS TO DEVELOP KEY INDICATORS FOR REPORTING FOR ACCREDITED SITES AND EXPLORED THE POSSIBILITY OF LEVERAGING THEIR CLINICAL EMERGENCY DATA REGISTRY DATA AS INPUT FOR DASHBOARD AND QI DATA. ADDITIONALLY UTILIZING THIS DATA LEVERAGES ACEP/GEDA APPLICATIONS TO INFORM RESEARCH STUDIES. USING STANDARDIZED METHODS FOR FUTURE RESEARCH OPPORTUNITIES (VA):WITH MORE THAN 200 ACCREDITED GEDS, SEVERAL PROTOCOLS WERE SET IN PLACE TO POSITION WHI AND THE DEPARTMENT OF VETERAN AFFAIRS (VA) FOR FUTURE RESEARCH. WHI SUPPORTED THE DEVELOPMENT AND IMPLEMENTATION OF STANDARDIZED INTERVENTIONS AND METRICS THAT ARE CAPTURED IN A NATIONAL DASHBOARD THAT PROVIDES REAL-TIME INFORMATION ON ED UTILIZATION AND GERIATRIC SCREENINGS IN VA HOSPITALS (GEDS AND NON GEDS). THIS IMPLEMENTATION WAS USED IN A DESCRIPTIVE ABSTRACT PRESENTED BY THE VA AT THE ACEP SCIENTIFIC ASSEMBLY IN OCTOBER 2022.PILOT TESTING A TOOLKIT TO ENABLE ALIGNED PARTNERSHIPS BETWEEN GEDS AND VALUE-BASED CARE ORGANIZATIONS:RESEARCH SHOWS GEDS CONTRIBUTE TO REDUCED HOSPITAL ADMISSIONS, FEWER READMISSIONS AND SAVINGS OF $1,200 - $3,200 PER MEDICARE BENEFICIARY WITHIN 60 DAYS OF THE INDEX ED VISIT. A MAJOR FOCUS OF VALUE-BASED CARE ORGANIZATIONS (VBCOS) IS REDUCING AVOIDABLE HOSPITAL ADMISSIONS AND THEY TYPICALLY HAVE THE FINANCIAL AND QUALITY INCENTIVES TO PROVIDE CARE BEST MATCHED TO THE NEEDS OF THEIR BENEFICIARIES. FOR THESE REASONS AND MORE, WE BELIEVE THERE ARE GREAT OPPORTUNITIES TO INVESTIGATE IMPROVED CARE AND LOWER COST FOR OLDER ADULTS BY FOSTERING MEANINGFUL VCBO/GED RESEARCH PARTNERSHIPS.IN 2022, WE LAUNCHED A SUCCESSFUL RESEARCH COLLABORATION WITH FOUR HEALTH SYSTEM HOSPITAL GEDS INCLUDING ADVOCATE AURORA (WISCONSIN), ST JOSEPH'S HEALTH (NEW JERSEY), AND THE UNIVERSITY OF NORTH CAROLINA HEALTH SYSTEM, TO CULTIVATE PARTNERSHIPS WITH VBCOS (ACCOUNTABLE CARE ORGANIZATIONS, CLINICALLY INTEGRATED NETWORKS, AND PACE) WHOSE PATIENTS WERE BEING SEEN IN THE GEDS. COMMUNICATION AND QUALITY IMPROVEMENT ACTIVITIES WERE INVESTIGATED USING A WHI DEVELOPED "TOOLKIT" AS A GUIDE.
Geographies
Not indicated
Dates
Jan 1, 2022 – Dec 31, 2022
Source
990
No causes provided
No populations provided
–
$15.4M

GARY AND MARY WEST HEALTH INSTITUTE

GARY AND MARY WEST HEALTH INSTITUTE

GARY AND MARY WEST HEALTH INSTITUTE

Overview

Programs

990s

Income Statement

Balance Sheet

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Board & Team

Financial Trends

Funders

Grants Received

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Grants Given

Overlap

Programs

Program 1 [2020]

Program 2 [2020]

Geriatric Emergency Department Research

Programs