Health care reform and the changing training needs for those who care for the elderly

The Affordable Care Act will alter the way that health care and public health serve the elderly. Expanded insurance and care options will increase demand for providers to function at the top of their training level and in multi-disciplinary office and community-based teams. Care for the elderly will increasingly prioritize wellness, independence and patient-control with innovative approaches to expand the primary care medical home and to use global reimbursement to pay for previously uncovered services. I will highlight what we have learned about the likely changes from examining the experience of Massachusetts as it implemented health care reform. We have seen changes in areas that disproportionately affect the elderly - such as the reduction of preventable hospitalizations and proliferation of new service options in the home, including visits by community health workers and the use of adapted technology and communication advices. The scope of practice and training needs for some professions such as nursing and pharmacists are changing fast in order to keep up with these new conditions. Northeastern University has analyzed these changes and the impact they have on its nursing, physician assistant, pharmacist and public health programs. We have begun to adapt our training so our graduates will be prepared to care for the elderly. As a geriatric expert I have insured that particular attention is paid to the training needs associated with the aging population. As part of a health reform panel, I will highlight the lessons about training programs for the elderly in this new environment.