Author: Deborah Bouton

Forbes Magazine Highlights SASH as a Way to Reduce Medical Costs for Older Adults

An article by latest federal evaluation showing significant savings in Medicare/Medicaid costs, as well as happier, healthier people. SASH is “an important example of the potential advantages of pairing senior housing with services. It can help older adults stay at home longer, and may keep them out of the hospital and reduce Medicare costs,” Gleckman concludes.  Read the article here.

Federal Study Links SASH to Medicaid Savings for Long-Term Care

A new federal evaluation of Vermont’s groundbreaking “Support and Services at Home” (SASH) program, released July 12, 2019, shows significantly slower growth in the cost of long-term institutional care for very low-income SASH participants compared to non-participants. The finding holds true for SASH participants age 65 and older who receive Medicaid to cover the cost of long-term care in nursing homes. Medicaid costs were about $400 less per beneficiary per year among participants living at affordable-housing sites where SASH is based, researchers found.  Learn More.

New Study Links SASH to Medicaid Savings for Long-Term Care

The latest federal evaluation of Vermont’s groundbreaking “Support and Services at Home” (SASH) program, released July 12, 2019, hows significantly slower growth in the cost of long-term institutional care for very low-income SASH participants living in most areas of the state compared to non-participants.

The finding holds true for SASH participants age 65 and older who receive Medicaid to cover the cost of long-term care in nursing homes. Medicaid costs were about $400 less per beneficiary per year among participants living at affordable-housing sites where SASH is based, researchers found.

Vermont has a strong record of preventing and delaying nursing home care. For  more than a decade, home health agencies, area agencies on aging and adult day centers have helped hundreds of Vermonters stay living at home through a Medicaid–funded program called Choices for Care. This study shows that even in a state with a strong commitment to the independence of older Vermonters, the SASH model makes a difference.

“This is a significant finding because it shows that SASH delays or prevents nursing-home placement,” said Amy Kandilov, lead investigator of the study, which was conducted for the U.S. Department of Health & Human Services by RTI International and the LeadingAge Center for Applied Research. “It’s also one of the few programs we have evaluated that is having a favorable impact on both Medicare and Medicaid expenditures for the population served.”

Previous independent evaluations of SASH have documented savings in Medicare expenses for SASH participants, but this is the first time researchers honed in on SASH as it relates to Medicaid costs.

Most SASH participants live in congregate affordable housing. They are supported by a statewide network of social-service agencies and health-care partners, including nonprofit housing organizations, area agencies on aging, community mental health centers, home health agencies, primary and community care teams, and regional hospitals. Participants receive individualized support at home from a SASH care coordinator and a wellness nurse, who together with these partners help about 5,000 SASH participants live safely at home and avoid costly medical interventions. The program is free to participants, with funding provided by OneCare Vermont and the state of Vermont.

The authors of the study, “SASH Evaluation Findings, 2010-2016,” analyzed Medicare and Medicaid claims from 2011 to 2016 and surveyed participants and stakeholders to evaluate the impact exclusively of SASH on health status and well-being. They examined data for 54 Vermont panels (groups of approximately 100 SASH participants each) and 116 affordable-housing communities that host SASH.

Researchers also confirmed that Medicare costs continue to be lower for SASH participants, especially those in urban areas ($1,450 less per beneficiary per year). The positive impact of SASH on total Medicare expenditures was driven by “statistically significant slower growth in Medicare expenditures for hospital stays, emergency room visits, and specialist physicians, which is consistent with the SASH program goal of preventing unnecessary high-cost care,” Kandilov added.

Researchers also affirmed earlier findings that SASH participants report greater ease managing their medications and, at housing sites where SASH is based, that property managers credit SASH for diffusing tenant disputes and helping residents avoid eviction due to mental health and other challenges.

Robyn Stone DrPH, senior vice president for research at LeadingAge LTSS Center, emphasized the significance of the new study. “These findings should be of particular interest to policymakers at the federal and state levels as well as managed-care plans and other health systems that are responsible for the care of low-income older adults,” she said, adding, “Partnering with affordable senior-housing providers makes sense for payers, providers and consumers, both from a quality and a cost perspective.”

Read highlights and the full study, “SASH Evaluation Findings, 2010-2016.”

SASH Featured in U.S. News & World Report

SASH participant Jeanne Daley is featured in an article in U.S. News about her overall improvement in health and emotional well-being since moving into a residence where SASH is offered. The article dives into the “what” and “how” of the SASH model, speaking specifically to Daley’s successes. The article also touches on the interest of several states to replicate SASH within their borders. Read the full article here.

SASH Shown to Reduce Growth in Costs for Emergency Department and Specialist Visits

A study published in the national HUD research journal Cityscape identifies the traits of SASH groups (“panels”) that have the biggest bang when it comes to reducing Medicare expenditures. Among the findings: Visits to emergency rooms and specialty physicians by SASH participants in nearly all Vermont SASH panels cost less compared to the control group, with statistically significant savings among participants in the early and urban panels who are eligible for both Medicare and Medicaid. The study, conducted by RTI, was a deeper analysis of data RTI gathered during its most recent evaluation of SASH. Read the study here.

SASH Innovation Featured by National Organization

St. Johnsbury SASH participant Regina Fournier’s story is featured in an issue brief published by the Center for Consumer Engagement in Health Innovation as part of its series on highly effective programs serving older adults and people with disabilities. The brief itself discusses the huge success of SASH since its start in 2009. The overview walks through how the SASH program operates, showcasing why SASH was chosen as one of the most innovative programs supporting older adults and differently abled persons. Read the full brief here