Concerned about your Medicare dollars? Hospital program could save billions

Kathleen Blanchard's picture
ACE program shown to curb Medicare spending

Taking care of our nation’s elderly is a challenge that comes with a high price tag. As baby boomers age – the largest segment of the U.S. population – health care spending is also expected to soar. One way to curb health care spending is by establishing specialized hospital units that are focused on caring for older people.

Elderly care hospital units piloted throughout the country

Researchers from University of California, San Francisco (UCSF), assessed a program called Acute Care for Elders”, or ACE, that is currently being piloted in 200 hospitals across the nation.

Senior author Seth Landefeld, MD, chief of the UCSF Division of Geriatrics said in a press release, “This was really an opportunity to look at how you can deliver higher value care while maintaining or improving quality and reducing cost.”

Landefeld cites the rising cost of the Medicare health budget as impetus for the program, which he says “…is going up faster than anything else, and the cost of hospital stays is one of the fastest growing components of that care.”

When the researchers compared cost of traditional hospital care in a randomized controlled study among 1,632 elderly patients to the ACE program, they found elders were discharged sooner and the cost of hospitalization was $974 less per patient. The difference could mean an annual savings of $6 billion in Medicare expenditures.


Deborah Barnes, PhD, MPH, an associate professor of Psychiatry and Epidemiology & Biostatistics at UCSF explains shorter hospital stays and lower costs doesn’t mean decreased quality of care. “…Despite being released about half a day earlier, patients had similar levels of function at discharge, and also the readmission rates were identical in two groups over three months.”

Landefeld and his colleagues add there minor changes hospitals could make that would also add up to significant Medicare savings. One example is interrupting patients in the middle of the night for assessments can also disrupt healing and recovery time. Ensuring patients get out of their beds can also go a long way to curb Medicare spending.

The group also looked at the impact of involving, rather than isolating families from their loved ones. The ACE program involves families from the day of admission. Restructuring how hospitals work by establishing specialized units that care for older patients doesn’t mean nurses and other health care staff work harder. Instead, the researchers found …”that ACE decreased miscommunication and it decreased the number of pages nurses had to make to doctors,” Landefeld said. “Having people work together actually saved people time and reduced work down the line.”

The savings for Medicare is substantial. Landefeld explains the return is 5-fold relative to changes that would need to be made in hospital units.

Barnes said a program like ACE that targets caring for older hospitalized patients would work to curb Medicare spending, without compromising patient care. It’s just going to take people who believe in the benefits who are willing to make the upfront investment. The program saved about 10 percent in hospital costs and is shown in several studies to work. The next hurdle is to convince hospitals they can save money by investing in specialized units for their older patients.

June, 2012

Image credit: Morguefile