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© 2010. Copyright NCOA
National Council on Aging Falls Free© Initiative
• Coalition of 70 national organizations, professional associations and federal agencies; and 37 states working collaboratively to reduce falls and fall-related injuries among older adults
• Working to bring Health Care, Public Health and Aging together
• National Advocacy agenda:
Increase awareness
Increase investment in evidence-based programs and interventions
Strengthen reimbursement and fall prevention activities unfolding in Health Care Reform
© 2010. Copyright NCOA
Hawaii
AK
MT
ID
WA
CO
WY
NV
CA
NMAZ
MN
KS
TX
IA
WI
IL
KY
TN
INOH
MI
ALMS
AR
LA
GA
FL
SC
WVVA
NC
PA
VT
RI
ME
NHOR
SD
ND
MO
OK
NE
NY
CTNJ
MD
DE
NorthernMarianas
Guam
MA
States operating Fall Prevention Coalitions
Falls Free© Initiative: State Coalitions on Fall Prevention Workgroup
State Coalitions on Fall Prevention: A Compendium of Initiativeswww.healthyagingprograms.org/content.asp?sectionid=98&ElementID=746
States developing Fall Prevention Coalitions(updated February 2011)
State participating in CDC pilots of Tai Chi and/or Stepping On
© 2010. Copyright NCOA
0
20
40
60
80
100
1900 1950 2000 2050
65 OR OLDER
85 OR OLDER
2000: US Census Bureau, Decennial Census Data,
Population Projections
projected
Total Number of Persons Age 65 or Older by Age Group,
1900 to 2050, in Millions
Putting the Future in Perspective
Admission rates with
age (39% of fall-related
admissions are 85+)
An aging population, combined with increased life expectancy means the number of injurious and fatal falls will likely increase significantly.
© 2010. Copyright NCOA
Challenges, barriers and opportunities
Promoting awareness to the issue, belief in prevention
strategies, and sustained behavior change across all
stakeholders are keys to successfully reducing the rate of
injurious/fatal falls
© 2010. Copyright NCOA
Addressing challenges and barriers
• Some of the general public awareness activities include
• Promoting State and National Coalition activities
• Promoting collaboration across stakeholders and
enfolding key messages
• Congressional office visits
• Congressional briefing planned
• Fall Prevention Awareness Day
© 2010. Copyright NCOA
Hawaii
AK
MT
ID
WA
CO
WY
NV
CA
NMAZ
MN
KS
TX
IA
WI
IL
KY
TN
INOH
MI
ALMS
AR
LA
GA
FL
SC
WVVA
NC
PA
VT
RI
ME
NHOR
SD
ND
MO
OK
NE
NY
CTNJ
MD
DE
NorthernMarianas
Guam
MA
Falls Free© Initiative: 37 States Participating in Fall Prevention
Awareness Day 2010
State Coalitions on Fall Prevention: A Compendium of Initiativeswww.healthyagingprograms.org/content.asp?sectionid=98&ElementID=746
© 2010. Copyright NCOA
Addressing challenges and barriers
Provider Awareness, salience & behavior change challenges
• Some of the provider education and training activities include
• USPSTF Review of the clinical evidence
• AGS/BGS Guidelines providing a clinical algorithm
• HHS Prevention &Wellness fund investment in provider
training
• Fall Prevention Center of Excellence initiatives to train
providers and gerontology students
•NCOA partnership with Paraprofessional Health Institute to
develop home health aide training in fall prevention
• NH contracts with State Funded Health Clinics to screen all
older adults for falls
© 2010. Copyright NCOA
Addressing challenges and barriers
Physical Therapists and Occupational Therapists step up
•APTA, AOTA providing practitioners
with continuing education units
•Physical Therapy education and
training workgroup to influence
• Awareness
• Practice preparation
• Practice guidelines
• Research guidelines
© 2010. Copyright NCOA
Affordable Care Act
Annual Wellness Benefit Effective January 2011
routine measurements such as height, weight, blood pressure, body-
mass index;
review of medical and family history;
establishing a list of current providers, suppliers, and medications
(including supplements);
a personal risk assessment (including any mental health conditions);
a review of functional ability and level of safety;
detection of any cognitive impairment;
screening for depression;
establishing a schedule for Medicare’s screening and preventive
services your client qualifies for over the next 5 to 10 years; and,
any other advice or referral services that may help intervene and
treat potential health risks.
© 2010. Copyright NCOA
Addressing challenges and barriers
Reimbursement Challenges
• Medicare Reimbursement for Falls-Related Services and
treatment but what about Prevention?
• Falls V-code: Qualification of the Medicare V code 15.88
• Local coverage determinations vary across carriers
Reimbursement Activities
• Exploring Center for Medicare Innovation interest
• American Occupational Therapy Association Report on
Medicare challenges and opportunities
• Palmetto GBA efforts to strengthen home FP services
© 2010. Copyright NCOA
How will we make a real difference?
• Broad awareness to the issue – falls are not an
inevitable part of aging
• Training and education for providers
Investment in evidence-based programs, services and
resources - targeting prevention through risk
reduction – must be accessible to those at most risk
• Provide seamless transitions to community programs
from health care and vice versa
• Strengthen Healthcare Reimbursement for services
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