Today, 35% of people in our region are age 50 or older, yet most families and communities don’t have the resources to provide vital care to our aging population, especially in rural areas and tribal communities.
Since 2014, our Aging Services program’s goal has been to improve the quality of life of the region’s older adults by fostering conditions of dignity and respect where they are free to age gracefully. With our regional partners, we utilize health coaching and integrated medication management to transform the health of older adults in our region.
Community-based health coaches provide tailored education to patients around their chronic conditions, connect patients with necessary resources that address barriers related to social determinants of health, and practice patient-centered goal setting.
In 2018, Newport Hospital and Health Services launched an innovative integrated medication management pilot that equips high-risk, rural seniors with the skills for self-management of their prescriptions and overall health. The model coordinates primary care, pharmacy and social services under one service umbrella. Funding and resources from Empire Health Foundation (EHF) support pilot evaluation and exploration of advanced value-based payment models.
Confronting Inequity and Disparity
- 5 of 7 of the counties we serve have lower life expectancies than the state average.*
- Each of the 7 counties in EHF’s service area have higher rates of chronic disease than the state and national averages (heart, stroke, diabetes, cancer).*
*Source: healthdata.org/county resources
Newport Hospital and Health Services
In 2018, Newport Hospital and Health Services launched an innovative integrated medication management pilot that equips high-risk, rural seniors with the skills for self-management of their prescriptions and overall health. The model coordinates primary care, pharmacy and social services under one service umbrella. In rural health clinics, patients are extremely loyal to their providers, so adding pharmacists to health teams also adds another layer of trust. Funding and resources from EHF support pilot evaluation and exploration of advanced value-based payment models.
Spokane Tribe of Indians
Employing three health coaches and one care coordinator with the help of Empire Health Foundation, the Spokane Tribe has decreased hospital/emergency room visits and stays for Elders and other older adult community members, while increasing self-management of medical care and improving health outcomes and quality of life. The Spokane Tribe’s health coaching program empowers them to set their own health goals, helps them manage chronic conditions, and connects them with resources to overcome barriers related to social determinants of health. In tandem with the health coaching, the Spokane Tribe’s Stay Active and Independent for Life (SAIL) fitness program helps older adults increase balance and strength while providing a space for social interaction.
Before Margaret enrolled in our health coaching program on the Spokane reservation, she was struggling to manage her diabetes and high blood pressure. She was withdrawn, knew little about her medical conditions or her medicine, and didn’t have a plan to get healthy. Margaret told us she was just living day to day, thinking she would forever have to suffer. Today, she is so much happier and healthier. She has transitioned from poor health and daily stress to feeling healthy and in control, and is now well-equipped to live the rest of her life
in her own home.”
“Management of high-risk or moderate-risk patients must include elements of health care that are typically difficult to maintain, such as medications and social determinants of health. This program offers another level of assistance.”
“EHF has always backed us up, supporting us in doing some amazing things around improving the health of our seniors. The health coaching is working and our seniors are becoming healthier.”