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FACT SHEET October 14, 1998 Contact: HCFA Press Office (202) 690-6145
Chronic disease is the leading cause of death, severe illness and disability in the United States, accounting for three out of four deaths and affecting more than 100 million people. Eighty percent of the senior population have one or more chronic diseases, 50 percent have two or more chronic conditions, and 24 percent have severe chronic conditions that limit their ability to perform one or more activities of daily living.
Direct medical costs for persons with chronic conditions represent nearly 70 percent of national expenditures on health care. Research indicates that a major portion of the physical decline among the elderly is caused more by the absence of comprehensive health promotion and disease prevention strategies than by aging.
A growing body of medical literature indicates that chronic disease and functional disability can be measurably reduced or postponed through lifestyle changes, and that healthy behaviors are particularly beneficial for the elderly. Exercise--even if started later in life--along with diet, smoking cessation, clinical preventive services, and meaningful activity and socialization, can improve functioning and reduce disease and disability in old age.
Reduction of chronic disability in the elderly should result in lower rates of morbidity and functional disability and should produce considerable savings for Medicare.
The Healthy Aging Project will use the best available science to identify what works to promote health and prevent functional decline in older populations, and will apply this information in practical ways to Medicare programs and policies. Many health promotion and disease prevention programs have been shown to reduce risk factors and lower health care costs, but these programs have never been compiled, rigorously evaluated or tested for effectiveness in the Medicare population.
The Healthy Aging Project is the Health Care Financing Administration's first initiative to examine ways to reduce behavioral risk factors in the elderly, which contribute to 70 percent of the physical decline that occurs with aging. The Healthy Aging Project will identify and test interventions to reduce behavioral risk factors in the managed care and fee-for-service settings.
Examples of interventions include: health risk appraisals combined with targeted interventions to reduce risk factors, arthritis self-management programs, smoking cessation strategies, and home-based geriatric assessments to reduce falls and nursing home admissions.
The Healthy Aging Project will examine whether health promotion interventions have a measurable impact on behavior change, health status, functional status, quality of life, use of services, consumer satisfaction, or cost of care. The project will also identify ways to promote the use of Medicare clinical preventive services, such as flu shots, colorectal cancer screening, and mammograms.
The Healthy Aging Project will provide strategies that beneficiaries, health care professionals, peer review organizations, and communities can use to promote health and delay disease in older populations.
HCFA has awarded a contract to the RAND Corp. of Santa Monica, Calif., to conduct the activities of the Healthy Aging Project. The primary subcontractor is the Connecticut Peer Review Organization.
The Healthy Aging Project was jointly developed by HCFA and the Agency for Health Care Policy and Research, in consultation with the National Institute on Aging, the National Heart, Lung, and Blood Institute, the Administration on Aging, and the Centers for Disease Control and Prevention.