AGS Spotlight

Do Your Part to Achieve High-Quality, Patient-Centered Care

Barney S. Spivack, MD, FACP, AGSF, CMD Associate Physician Editor, Clinical Geriatrics

Millions of Americans have what are known as “advanced illnesses”—these include diseases such as heart disease, cancer, chronic obstructive pulmonary disease, and dementia. Advanced illnesses meet three criteria: (1) they are serious enough to undermine functioning; (2) patients eventually stop responding to treatment; and (3) the illness ultimately leads to death. The prevalence of advanced illnesses is expected to increase significantly as the population ages. Yet, while these health problems are more common in later life, people may develop advanced illnesses at any age. Like many older adults—especially those with complex, interacting medical problems—people with advanced illnesses, regardless of their age, need something that is currently in short supply nationwide: seamless, patient-centered, high-quality, coordinated care.

To help rectify this issue, a newly established organization called the Coalition to Transform Advanced Care (C-TAC) last month launched a major initiative aimed at ensuring that those with advanced illnesses receive the high-quality, coordinated, patient-centered care they need and want. The nonprofit, nonpartisan coalition is comprised of more than 60 diverse organizations, including the American Geriatrics Society (AGS), AARP, and other healthcare, long-term care, hospice care, and eldercare organizations. Its members also include patient and consumer advocacy organizations and faith-based groups, as well as healthcare payers and other stakeholders.

“C-TAC’s mission is four-fold,” explains AGS Chief Executive Officer Jennie Chin Hansen, RN, MSN, FAAN, who has been appointed a co-chair of C-TAC’s Steering Committee. “Our goals are to develop and disseminate innovative and high-quality models of comprehensive, coordinated care; promote these models across care settings; help patients and their families get quality, patient-centered care that conforms to their wishes; and effect policy and regulatory changes that support such care.”

Providing high-quality, coordinated, patient-centered care is, of course, the goal of geriatric care as well. It’s something the AGS, both independently and in coalition with like-minded organizations, has been promoting since its inception. Joining forces with the broad-based C-TAC will help us make further progress toward that shared goal.

In addition to Hansen, AGS member Diane Meier, MD, Director of the Center to Advance Palliative Care and Professor of Geriatrics and Palliative Medicine at Mount Sinai School of Medicine, is also a member of the coalition’s Steering Committee. This is important. Given geriatric healthcare providers’ expertise in caring for complex patients and their experience with models of coordinated, patient-focused care, those of us in the field should play leadership roles in this initiative. And in light of the challenges inherent in effecting widespread transformative change, it’s equally important that as many of us in geriatric care as possible participate in this effort. C-TAC welcomes the involvement of both organizations and individuals. Getting involved is easy. Simply send an e-mail expressing your interest to I hope you’ll do so.

There are a growing number of opportunities for geriatrics healthcare professionals to play roles in advancing quality care for our patients. Just weeks before C-TAC released its plan, the Centers for Medicare & Medicaid Services (CMS) announced it would launch its Comprehensive Primary Care Initiative (CPCI) in the summer of 2012. The initiative is designed to promote the kind of models of care that AGS and C-TAC are working to advance—patient-centered, coordinated models. Practices participating in CPCI will be paid patient management fees, which are expected to be roughly $20 per patient per month, to cover various costs associated with implementing the models, such as adding staff or adopting health information technology to improve implementation. CMS will also provide practices with patient and resource-use data so they have more information on the quality of care they provide and on their physicians’ performances. In addition, any savings resulting from these innovations will be shared with the practices. For further details and to find out how you can participate, visit

As Mary Tinetti, MD, indicated during her Henderson State-of-the-Art Lecture on falls during the AGS Annual Scientific Meeting earlier this year, this is an exciting time to be in geriatrics, and there are many opportunities to use our knowledge, skills, and considerable resources to improve the health of older adults and to make the healthcare system work better. The AGS will continue to provide more information about these and other initiatives in the months to come.

Dr. Spivack is Medicare Medical Director, UnitedHealthcare Medicare & Retirement, Westport/Trumbull, CT; Founder, Connecticut Geriatrics Society; Consultant in Geriatric Medicine, Greenwich Hospital, Greenwich, CT, and Stamford Hospital, Stamford, CT.

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