The Pension Factor: Assessing the Role of Defined Benefit Plans in Reducing Elder Hardships

Traditional defined benefit (DB) pension plans have long been an important source of income for elder households seeking to maintain a middle-class standard of living after a lifetime of work. Under traditional DB plans, retirees receive a guaranteed, regular stream of income after retirement that continues until death. The monthly pension benefit is typically based on years of service to the employer, age, and salary history. Retirees also have the option to elect a joint-and-survivor benefit, to ensure that pension payments continue to a surviving spouse. DB plan participation rates among private sector American workers have sharply decreased from about 38 in 1980 to 20 percent in 2008. DB plan coverage in the public sector has not followed this same trend. Overwhelmingly, employees of local, state or federal government are covered by a traditional pension plan. For the same time period, the percentage of private sector workers covered by a defined contribution (DC) retirement plan, such as 401(k) plans, rose from 8 to 31 percent. Under such DC plans, employers and/or employees make contributions to a retirement savings account. Employees typically need to decide how to invest these sums in order to produce accumulated savings for income at retirement. Recent turmoil in financial markets has substantially reduced the DC plan retirement savings of many workers and retirees alike. This has heightened public concerns that many older American households will not accumulate sufficient retirement savings to meet their needs in retirement. Although investment losses certainly have adversely affected the funding of many DB plans, the predictable monthly benefits of DB plans remain a source of security to retired households who have these plans

The Alzheimer’s Association Dementia Care Coordination Program: A Process Evaluation, Executive Summary

The Massachusetts/New Hampshire (MA/NH) Chapter of the Alzheimer\u27s Association has long sought ways to systematically increase the number of families who utilize its services and support. According to the Alzheimer’s Association’s 2015 Alzheimer’s Disease Facts and Figures, there are 142,000 individuals living with Alzheimer’s disease in Massachusetts and New Hampshire, and the Alzheimer’s Association estimates that less than 30% of those individuals and their caregivers take advantage of its programs (Alzheimer’s Association, 2015). The MA/NH Chapter recognized that one major barrier to accessing services is a model that relies on families taking the initiative to seek out assistance. In 2005, The MA/NH Chapter of the Alzheimer’s Association initiated the Health Liaison Program. Rather than relying on affected persons to reach out to the Chapter, the Health Liaison Program sought to improve chapter service utilization by encouraging health care providers to make direct referrals for families affected by Alzheimer’s disease and related dementias (ADRD). After many years of operating the Health Liaison Program with existing staff, the Alzheimer’s Association MA/NH Chapter decided to pursue funding to expand the Health Liaison Program into the more formal Dementia Care Coordination (DCC) program. This study reports on the Dementia Care Coordination (DCC) Program. In 2013, with support from a non-profit health insurer, Tufts Health Plan (THP) and a private funder, the Eisenberg Family Trust, the development and implementation of the DCC Program became possible. Under the DCC Program, dedicated care consultants connect directly with persons with ADRDs and their families who are referred to the Chapter by health care providers. Once connected, the care consultant is able to provide disease-specific education, symptom management strategies, emotional support, and referrals to community resources and encourage the caregiver to utilize other Alzheimer’s Association services including support groups, education programs, and advocacy opportunities. Consultants collaborate with other staff members and volunteers to provide ongoing information and support to families. Moreover, consultants provide written feedback to health care providers and nurse case managers on client needs and recommendations to meet those needs. Connecting families affected by ADRD with the services and support of the Alzheimer’s Association has important benefits for both the caregiver and affected person. Integrating primary care with caregiver support will likely improve the health status and quality of life for the person with ARDA and family caregivers. Mittleman et al. (2006) has demonstrated that such support and education delays institutionalization and improves physical and emotional health outcomes for the caregiver. Unfortunately, many caregivers delay seeking any kind of assistance. Richardson (2012) reporting on a 2012 study by the Alzheimer Society of Canada, stated that 44% of caregivers for people with ADRD waited a year or more, after the first signs of dementia, to seek any kind of support. The overall finding of this study is that the DCC program is highly successful and has engendered high levels of satisfaction by participants and multiple stakeholders. The DCC program represents an important element in a comprehensive integrated approach to patient care. Our analysis has also led us to make recommendations on how this important program can be improved, with the hope that it can be expanded and replicated

Risk Factors for Driving Cessation Vary by Race and Ethnicity

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and older), including whites (85%), African Americans (8%), Hispanic (5%), and other race (2%)

Massachusetts Healthy Aging Data Report: Community Profiles

The Massachusetts Healthy Aging Data Report: Community Profiles was created by researchers at the Gerontology Institute of the John W. McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston and commissioned by the Tufts Health Plan Foundation. In this report, we have created a custom profile of nearly 100 healthy aging indicators for every city and town in Massachusetts including the 16 neighborhoods of Boston (367 Community Profiles). Each Community Profile is designed to help community residents, agencies, providers, and governments understand the older adults who live in their cities and towns – their ages, living arrangements, health status, strengths, and vulnerabilities. Never before has Massachusetts had such a comprehensive view of healthy aging indicators reported at this local geographic level

Adjusting Medicare capitation payments using prior hospitalization data

The diagnostic cost group approach to a reimbursement model for health maintenance organizations is presented. Diagnostic information about previous hospitalizations is used to create empirically determined risk groups, using only diagnoses involving little or no discretion in the decision to hospitalize. Diagnostic cost group and other models (including Medicare\u27s current formula and other prior-use models) are tested for their ability to predict future costs, using R2 values and new measures of predictive performance. The diagnostic cost group models perform relatively well with respect to a range of criteria, including administrative feasibility, resistance to provider manipulation, and statistical accuracy

Examining the Nest Egg: The Sources of Retirement Income for Older Americans

The spending by 27 million retired Americans from their monthly pension payments in 2016 supported 7.5 million jobs for other Americas and $1.2 trillion in total economic output nationwide.What is the impact in your state? Click on a st"A new report finds that a large portion (40 percent) of older Americans rely only on Social Security income in retirement while only a small percentage of older Americans (seven percent) receive income from Social Security, a defined benefit pension, and a defined contribution account. Retirement income from these three sources is widely considered to be the ideal situation to ensure retirement security, particularly for the middle class. Retirees with these three sources of income are far less likely to face poverty and economic hardship.These findings are contained in a new report from the National Institute on Retirement Security (NIRS), Examining the Nest Egg: The Sources of Retirement Income for Older Americans. The report is co-authored by Tyler Bond, NIRS manager of research, and Dr. Frank Porell, University of Massachusetts Boston professor emeritus.The analysis also finds that without income from Social Security in 2013, the number of poor older U.S. households would have increased by more than 200 percent to 11 million households. Absent income from defined benefit pensions, the number of poor older households would have increased by 19 percent to more than four million households in 2013. Defined contribution plans, however, are less powerful at keeping older households out of poverty than pensions and Social Security because fewer near-poor households have assets in 401(k)-style defined contribution accounts and income from those accounts provided a smaller portion of total income. Without income from defined contribution accounts, the estimated number of poor older households would have increased by five percent."ate to download a Fact Sheet with details.Click "Download" to access this resource

The Pension Factor: Assessing the Role of Defined Benefit Plans in Reducing Elder Hardships

Traditional defined benefit (DB) pension plans have long been an important source of income for elder households seeking to maintain a middle-class standard of living after a lifetime of work. Under traditional DB plans, retirees receive a guaranteed, regular stream of income after retirement that continues until death. The monthly pension benefit is typically based on years of service to the employer, age, and salary history. Retirees also have the option to elect a joint-and-survivor benefit, to ensure that pension payments continue to a surviving spouse. DB plan participation rates among private sector American workers have sharply decreased from about 38 in 1980 to 20 percent in 2008. DB plan coverage in the public sector has not followed this same trend. Overwhelmingly, employees of local, state or federal government are covered by a traditional pension plan. For the same time period, the percentage of private sector workers covered by a defined contribution (DC) retirement plan, such as 401(k) plans, rose from 8 to 31 percent. Under such DC plans, employers and/or employees make contributions to a retirement savings account. Employees typically need to decide how to invest these sums in order to produce accumulated savings for income at retirement. Recent turmoil in financial markets has substantially reduced the DC plan retirement savings of many workers and retirees alike. This has heightened public concerns that many older American households will not accumulate sufficient retirement savings to meet their needs in retirement. Although investment losses certainly have adversely affected the funding of many DB plans, the predictable monthly benefits of DB plans remain a source of security to retired households who have these plans

The Alzheimer’s Association Dementia Care Coordination Program: A Process Evaluation, Executive Summary

The Massachusetts/New Hampshire (MA/NH) Chapter of the Alzheimer\u27s Association has long sought ways to systematically increase the number of families who utilize its services and support. According to the Alzheimer’s Association’s 2015 Alzheimer’s Disease Facts and Figures, there are 142,000 individuals living with Alzheimer’s disease in Massachusetts and New Hampshire, and the Alzheimer’s Association estimates that less than 30% of those individuals and their caregivers take advantage of its programs (Alzheimer’s Association, 2015). The MA/NH Chapter recognized that one major barrier to accessing services is a model that relies on families taking the initiative to seek out assistance. In 2005, The MA/NH Chapter of the Alzheimer’s Association initiated the Health Liaison Program. Rather than relying on affected persons to reach out to the Chapter, the Health Liaison Program sought to improve chapter service utilization by encouraging health care providers to make direct referrals for families affected by Alzheimer’s disease and related dementias (ADRD). After many years of operating the Health Liaison Program with existing staff, the Alzheimer’s Association MA/NH Chapter decided to pursue funding to expand the Health Liaison Program into the more formal Dementia Care Coordination (DCC) program. This study reports on the Dementia Care Coordination (DCC) Program. In 2013, with support from a non-profit health insurer, Tufts Health Plan (THP) and a private funder, the Eisenberg Family Trust, the development and implementation of the DCC Program became possible. Under the DCC Program, dedicated care consultants connect directly with persons with ADRDs and their families who are referred to the Chapter by health care providers. Once connected, the care consultant is able to provide disease-specific education, symptom management strategies, emotional support, and referrals to community resources and encourage the caregiver to utilize other Alzheimer’s Association services including support groups, education programs, and advocacy opportunities. Consultants collaborate with other staff members and volunteers to provide ongoing information and support to families. Moreover, consultants provide written feedback to health care providers and nurse case managers on client needs and recommendations to meet those needs. Connecting families affected by ADRD with the services and support of the Alzheimer’s Association has important benefits for both the caregiver and affected person. Integrating primary care with caregiver support will likely improve the health status and quality of life for the person with ARDA and family caregivers. Mittleman et al. (2006) has demonstrated that such support and education delays institutionalization and improves physical and emotional health outcomes for the caregiver. Unfortunately, many caregivers delay seeking any kind of assistance. Richardson (2012) reporting on a 2012 study by the Alzheimer Society of Canada, stated that 44% of caregivers for people with ADRD waited a year or more, after the first signs of dementia, to seek any kind of support. The overall finding of this study is that the DCC program is highly successful and has engendered high levels of satisfaction by participants and multiple stakeholders. The DCC program represents an important element in a comprehensive integrated approach to patient care. Our analysis has also led us to make recommendations on how this important program can be improved, with the hope that it can be expanded and replicated

The Alzheimer’s Association Dementia Care Coordination Program: A Process Evaluation, Executive Summary

The Massachusetts/New Hampshire (MA/NH) Chapter of the Alzheimer\u27s Association has long sought ways to systematically increase the number of families who utilize its services and support. According to the Alzheimer’s Association’s 2015 Alzheimer’s Disease Facts and Figures, there are 142,000 individuals living with Alzheimer’s disease in Massachusetts and New Hampshire, and the Alzheimer’s Association estimates that less than 30% of those individuals and their caregivers take advantage of its programs (Alzheimer’s Association, 2015). The MA/NH Chapter recognized that one major barrier to accessing services is a model that relies on families taking the initiative to seek out assistance. In 2005, The MA/NH Chapter of the Alzheimer’s Association initiated the Health Liaison Program. Rather than relying on affected persons to reach out to the Chapter, the Health Liaison Program sought to improve chapter service utilization by encouraging health care providers to make direct referrals for families affected by Alzheimer’s disease and related dementias (ADRD). After many years of operating the Health Liaison Program with existing staff, the Alzheimer’s Association MA/NH Chapter decided to pursue funding to expand the Health Liaison Program into the more formal Dementia Care Coordination (DCC) program. This study reports on the Dementia Care Coordination (DCC) Program. In 2013, with support from a non-profit health insurer, Tufts Health Plan (THP) and a private funder, the Eisenberg Family Trust, the development and implementation of the DCC Program became possible. Under the DCC Program, dedicated care consultants connect directly with persons with ADRDs and their families who are referred to the Chapter by health care providers. Once connected, the care consultant is able to provide disease-specific education, symptom management strategies, emotional support, and referrals to community resources and encourage the caregiver to utilize other Alzheimer’s Association services including support groups, education programs, and advocacy opportunities. Consultants collaborate with other staff members and volunteers to provide ongoing information and support to families. Moreover, consultants provide written feedback to health care providers and nurse case managers on client needs and recommendations to meet those needs. Connecting families affected by ADRD with the services and support of the Alzheimer’s Association has important benefits for both the caregiver and affected person. Integrating primary care with caregiver support will likely improve the health status and quality of life for the person with ARDA and family caregivers. Mittleman et al. (2006) has demonstrated that such support and education delays institutionalization and improves physical and emotional health outcomes for the caregiver. Unfortunately, many caregivers delay seeking any kind of assistance. Richardson (2012) reporting on a 2012 study by the Alzheimer Society of Canada, stated that 44% of caregivers for people with ADRD waited a year or more, after the first signs of dementia, to seek any kind of support. The overall finding of this study is that the DCC program is highly successful and has engendered high levels of satisfaction by participants and multiple stakeholders. The DCC program represents an important element in a comprehensive integrated approach to patient care. Our analysis has also led us to make recommendations on how this important program can be improved, with the hope that it can be expanded and replicated