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Reducing Disability via a Bundled Bio-Behavioral-Environmental Approach (CAPABLE)

Sarah Szanton
Assistant Professor, Department of Community-Public Health, School of Nursing, Principal Investigator


Sarah Szanton, PhD, CRNP an associate of the Hopkins Population Center (HPC) awarded early career support from the HPC has received an RO1 from the National Institute on Aging to study an innovative, bundled intervention to help keep at risk low income seniors at home and out of a nursing home.  300 Medicaid and Medicare eligible seniors in Baltimore city will be able to benefit from this project. Selected from over 3,000 submissions, Szanton’s project is also the only nursing school-based application to receive a Health Care Innovation Awards from the Center for Medicare and Medicaid Services, U.S. Department of Health and Human Services.  And thanks to the $4 million grant, Szanton will demonstrate how with a small investment in a nurse, occupational therapist and handyman, CAPABLE can both make a positive difference in the health of at-risk older adults on Medicare and Medicaid and lower their health care costs, too. 

CAPABLE, short for “Community Aging in Place, Advancing Better Living for Elders” will use a randomized, controlled trial to test the effect of this home-based disability reduction intervention.  To be an CMS Health Care Innovator, Szanton had to demonstrate that CAPABLE not only can improve care, but also that it can help save precious federal and state Medicaid and Medicare dollars. Because CAPABLE is built on a strong research base, Szanton expects the $4 million grant will effect a savings of $6 million in reduced hospitalizations and nursing home admissions, a net saving of $2 million over the 3-year grant period.  That translates to a 25% reduction in hospitalizations and a 40% drop in nursing home placements among the 500 program participants. 

In addition, in May 2012 Szanton partnered with the Hopkins Population Center Information Core Director to submit a successful request for two years of supplemental funding to provide specialized information and data enhance the work of this project.  Informationists will assist with capture of medical billing information from the participants; assist with use of GIS neighborhood data; identify approaches for analyzing digital recordings of interviews; assist with deposit of manuscripts in compliance with NIH Public Access.