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The GRACE Team Care Approach in Managing High-Risk Medicare Populations 
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A new study on “Effective Management of High-Risk Medicare Populations” recently released by Avalere Health focused on ways for payers and providers to better manage the cost of high-risk Medicare beneficiaries – typically older adults with multiple chronic conditions and functional impairment. The study revealed that to be successful in this effort, health plans and physicians need to not only focus on treating a person’s medical condition but must also have strategies in place for managing a broad array of care needs across multiple settings.

The study cited the GRACE Team Care (Geriatric Resources for Assessment and Care of Elders) program from Indiana University School of Medicine to be among the nation’s most successful in effectively managing high-risk Medicare populations. First launched at Eskenazi Health in Indianapolis, today GRACE Team Care is also offered through the Medicare Advantage program of Indiana University Health Plans Inc. and is being successfully applied at several other health plans, medical groups and VA hospitals in select markets around the country. In a model presented in the study, GRACE produced annual savings for high-risk members of nearly $4,300 while producing an ROI per year for the health plan of 95 percent.

GRACE involves a team approach to managing a patient’s health, which has been proven to enhance quality of geriatric care in ways that optimize quality of life, and decrease excess healthcare use including avoidance of hospitalization and visits to the emergency department. GRACE may also prevent or delay the need for long-term nursing home placement by allowing seniors to stay in their homes with better support. The catalyst for the GRACE program is its support team, headed by a nurse practitioner and a social worker who support the primary care physician in fully addressing a patient’s health conditions and achieving a patient’s goal from the comfort of their own home. The GRACE team provides patients with specialized care for geriatric conditions (e.g., falls, depression and memory problems), healthcare education; medication management; and coordination of care between specialty physicians, the emergency department, hospitals and a broad array of community support services.

Please join Doctor Steven Counsell, Executive Director of GRACE Team Care program for a one hour examination of the GRACE Team Care Approach in Managing High-Risk Medicare Populations on Wednesday, April 29th, 2015 at 1PM Eastern.
Learning Objectives
Participants will be able to:
  1. Overview the components and evolution of the GRACE Team Care program.
  2. Review case studies of GRACE programs implemented across the country in a variety of settings.
  3. Examine use of dashboards to monitor quality indicators and help partners reach targeted quality goals.
  4. Ascertain the impact of continuous patient education, health assessment, monitoring and counseling.
  5. Consider how the team care approach engages a wide variety of providers in the care transition process.
  6. Explore the implications in application of the GRACE Team Care approach to various populations.
  7. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow-up questions, and networking with attendees, faculty and other professionals through a dedicated LinkedIn group.
Who Should Attend

Interested attendees would include:

  • C-Suite Executives
  • Medical Directors
  • Population Management Executives and Staff
  • Care Management Executives and Staff
  • Patient Engagement Executives and Staff
  • Medicare Operations Executives and Staff
  • Strategy and Planning Executives and Staff
  • Innovation and Transformation Executives
  • Clinical and Business Intelligence Staff
  • Other Interested Parties

Attendees would represent organizations including:

  • Health Plans 
  • Provider Networks
  • Accountable Care Organizations
  • Hospitals and Health Systems
  • Pharmaceutical Organizations
  • Care Management Organizations
  • Solutions Providers 
  • State and Local Government Agencies
  • Associations, Institutes and Research Organizations 
  • Media
  • Other Interested Organizations
The GRACE Team Care Approach in Managing High-Risk Medicare Populations 
  Individual Registration Fee: $195. Post-event materials, with video syncing slides and recorded audio, plus presentation pdf file: $45 for attendees; $260 for non-attendees after the event. Register online or download the event brochure. Attendees also receive a complimentary three month subscription to Readmissions News.
Register Now   Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!
Steven Counsell

Steven Counsell, M.D. Executive Director
GRACE Team Care, Indiana University
  Steven R. Counsell, MD is the Mary Elizabeth Mitchell Professor and Chair in Geriatrics at Indiana University (IU) School of Medicine and Founding Director of IU Geriatrics, a John A. Hartford Foundation Center of Excellence in Geriatric Medicine. He is the Geriatrics Service Line Chief for IU Health Physicians and Chief of Geriatrics at Eskenazi Health, a public safety-net health care system in Indianapolis, Indiana.

Dr. Counsell traveled to Australia, where, as a 2008-2009 Australian-American Health Policy Fellow, he studied “Innovative Models of Coordinating Care for Older Adults.” Prior to his sabbatical, he served as Geriatrician Consultant to the Indiana Medicaid Office of Policy and Planning. He is a fellow of the American Geriatrics Society (AGS), past Chair of the AGS Public Policy Committee, and currently serves as President-Elect and member of the AGS Board of Directors.

Dr. Counsell has conducted large-scale clinical trials that tested system level interventions aimed at improving quality, outcomes, and cost-effectiveness of health care for older adults. He was the principal investigator for the NIH-funded trial of the Geriatric Resources for Assessment and Care of Elders (GRACE) care management intervention.

GRACE was shown to improve quality and outcomes of care in low-income seniors and reduce hospital utilization in a high risk group. Dr. Counsell was a 2009-2010 Health and Aging Policy Fellow and is currently leading GRACE Team Care™ dissemination initiatives, while working to influence health policy to improve integration of medical and social care for vulnerable elders.
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