Forum Session

Filling the Geriatric Gap: Is the Health System Prepared for an Aging Population?
January 25, 1999


Janet Firshein, Consultant & Nora Super


This meeting explored the field of geriatrics, the ways practitioners meet the health care needs of the elderly, training gaps, and the impact of Medicare payment policies on the delivery of health care to older Americans. The session gave meeting participants an opportunity to explore the delivery of health care to elderly individuals as opposed to its financing. The speakers, who shared a breadth of experience and knowledge, described the perverse incentives inherent in Medicare reimbursement policies and the ways they negatively affect the quality of care delivered to Medicare beneficiaries. For example, one speaker provided compelling evidence regarding the number of transfer rates from nursing homes to hospitals (which is directly related to Medicare reimbursement policy) and the negative consequences to patients' health.


Christine K. Cassel, MD, MACP, Chairman, Department of Geriatrics and Adult Development, Mount Sinai Medical Center; Mathy Mezey, EdD, Director, John A. Hartford Foundation Institute for the Advancement of Geriatric Nursing Practice, New York University; Richard Della Penna, MD, Physician-in-Charge, Continuing Care Services, Home Health, and Hospice, San Diego Kaiser Permanente Medical Group

Related Materials

More information available in the accompanying publication, Issue Brief No. 729.

See also the Institute of Medicine report, "Retooling for an Aging America: Building the Health Care Workforce" (April 2008).

Related Forum products include Forum sessions on primary care (December 9, 2002) and the physician supply and changing demographics (September 10, 2002), as well as a paper on managing costs and quality when treating advanced illness (Issue Brief No. 779, June 20, 2002).

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