Trellis surveyed older adults to understand their interest in using services and supports that would help them stay at home and in their communities. Survey respondents were past participants of Juniper evidence-based health promotion classes.
The survey results make a compelling case that older adults value home and community-based services such as transportation, chores, indoor and outdoor home maintenance and homemaking services. Many indicated they would be motivated to choose health plan coverage that pays for such services.
It’s not news that most older Americans want to age in place. The 2021 “Home and Community Preferences Survey” conducted by AARP finds that “77% of adults 50 and older want to remain in their homes for the long term — a number that has been consistent for more than a decade.”
Yet to remain in their own homes, many older adults will need both medical care and supportive services. People who cannot pay for home and community-based services out of pocket are left to navigate a fragmented array of services funded by the Older Americans Act, Minnesota’s Elderly Waiver and related government programs, foundations and private philanthropy.
Those who don’t qualify for low-income subsidies often go without or depend upon family and friend caregivers. A 2020 report by AARP found that almost 42 million Americans are caring for an adult 50 years of age or older — a 22% increase from 2015. Notably, about one in four of these caregivers said, “it is difficult to get affordable services in their recipient’s area.”
In 2018 and 2019, the Centers for Medicare and Medicaid Services (CMS) released guidance allowing reimbursement for home and community-based services in Medicare Advantage (MA) plans. This additional source of coverage will provide new avenues for access to these essential services.
Goals of the survey
The goals of the survey were to learn:
- What services and supports older adults feel they need to live independently in their own homes.
- The level of awareness of, and willingness to use, the available home and community-based services if they needed them.
- How they would obtain those services if they needed them (without reference to payment or reimbursement).
- The likelihood of them using those services — if they were available through their health plan — and how that availability would influence their choice of health plans.
Dawn Simonson, president and CEO of Trellis, said the results of the survey shed light on older adults’ needs now and into the future. She noted: “We believe information from the survey could help healthcare and community-based organizations and other stakeholders better tailor future benefits and services they offer to their members, patients and communities they serve.”
Survey findings
Responses to the survey questions showed that:
- The most desired services were indoor repair and maintenance, outdoor home repair and maintenance and transportation. Other sought-after services included homemaker-chore help and home modifications to make their homes safer.
- Help and support for family caregivers rated high on the list.
- Most respondents said they would hire an outside service provider to deliver needed services rather than depend on family members. The exceptions were for medication management, transportation and homemaker chores.
- Cost was the leading consideration in hiring an outside service provider, followed by the reliability and qualifications of the provider and safety and security.
- Seventy-five percent of respondents said that having non-clinical services and supports available to them would affect their health plan enrollment decisions.
Technology use and trusted sources of health information
Survey responses indicate that concerns about inaccessibility to technology for communication purposes among older adults may be overstated. Respondents to this survey said they regularly used many devices and are comfortable using smartphones, landlines, tablets, notebooks and laptops.
When it comes to health-related information, respondents trust only three sources to any substantial degree: overwhelmingly, “physician or another healthcare provider” (91%), followed by “family or friends” (43%) and health plan mailed information” (39%). This data reinforces the important role that healthcare providers and healthcare plans have in fostering whole-person care for older adults.
