The US is getting old. By 2030, about one in five people will be older than 65—and that age group makes up a big chunk of healthcare utilization.

Adults 65 and older account for more than 40% of hospital admissions and tend to stay in the hospital longer than younger age groups. That means geriatric care will be an increasingly important part of the healthcare system in the coming years. But there aren’t nearly enough geriatricians to care for the aging population—the Department of Health and Human Services estimates the US will be short almost 27,000 geriatricians by 2025.

To help fill in the care gap, Mount Sinai, one of the largest health systems in New York City, started a program in 2016 called Align, which stands for “aging, life innovations, goals, and needs.”

“The US healthcare system is too slow to adapt to the much-needed changes in our rapidly aging population, and we therefore need to create innovative models of care to address these healthcare gaps,” Stephanie Chow, a Mount Sinai geriatrician who serves as director of the Align program, told Healthcare Brew.

How it works.—MA

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Despite years of chronic understaffing at US nursing homes, researchers found that one federal program helped long-term care facilities improve staffing levels at the height of the Covid-19 pandemic—even as many healthcare systems struggled to retain workers.

Nursing homes that received loans from the Paycheck Protection Program (PPP), which Congress created in 2020 to offset pandemic-related business losses, added almost 46 staffing hours per week within three months compared to those that didn’t get PPP loans, according to a study published in JAMA Network Open on Thursday.

That boost equated to about “two additional shifts per week one month after receiving a loan and four additional shifts per week six months after receiving a loan,” Jasmine Travers, an assistant professor at NYU’s Rory Meyers College of Nursing and the study’s lead author, said in an emailed statement.

Certified nursing assistants (CNAs) experienced the greatest improvements in staffing at PPP recipient nursing homes, with 26 more hours each week, followed by licensed practical nurses (LPNs) with seven additional hours each week, the study found. However, staffing hours for registered nurses (RNs) didn’t change substantially.

Researchers also found that nursing homes with insufficient staffing levels, low quality scores, and more Medicaid patients were more likely to receive PPP loans.

The study, which examined staffing trends at nursing homes from January to December 2020, compared the hours LPNs, RNs, and CNAs worked before and after facilities got PPP loans. About 30% of the 6,000+ facilities researchers studied—or roughly 1,800 nursing homes—received PPP loans, with an average award of about $664,000.

Keep reading here.—SY

In honor of Minority/BIPOC Mental Health Awareness Month, Healthcare Brew asked our readers for insights into how their companies, hospitals, or practices are working to eliminate barriers and ensure equitable access to mental health services.

We’ve reported extensively on how racial disparities affect healthcare and patient outcomes, as well as how health systems are trying to improve health equity. But disparities also exist in mental and behavioral health—with outcomes varying widely among different racial and ethnic groups, according to a United Health Foundation (UHF) data brief released Tuesday.

American Indian/Alaska Native children, for example, are 14x more likely than their counterparts to undergo adverse experiences, such as divorce, a parent’s death, or living with someone with mental health or substance abuse issues, the UHF brief found. Meanwhile, the report noted that other minority racial populations were more likely to experience issues like major depressive episodes, substance use disorder, and co-occurring low-to-moderate mental illnesses.

Here’s how NewYork-Presbyterian staff among Healthcare Brew’s readers are working to address mental health care and access inequities:

The Uptown Hub: NewYork-Presbyterian, in collaboration with Columbia University Irving Medical Center and other community-based partners, established the youth opportunity hub in New York City’s Washington Heights and Inwood neighborhoods in 2017.

The Uptown Hub, which opened with the help of a four-year, $10.3 million grant, provides holistic and culturally affirming services to 250+ local residents—who are aged 14 to 24 and at risk for judicial system involvement—each year. NewYork-Presbyterian took over funding the program after the initial four-year grant lapsed.

The program aims to improve mental and physical health. It offers behavioral health, including individual therapy and one-on-one support, as well as clubs and workshops.

Keep reading here.—SY

Today’s top healthcare reads.

Stat: Healthcare spending grew to represent 20% of the GDP over the last 40 years, up from 8%. (Bloomberg Law)

Quote: “But you often can’t dig that out of notes. I think what we’re asking is kind of an untrackable number.”—Lynlee Wolfe, an assistant professor at the University of Tennessee Medical Center, on the difficulties in tracking maternal deaths due to restricted abortion access (ProPublica)

Read: A New York resident who lived to be 112 is among a group of Ashkenazi Jews studied for their “good health and cognitive ability at extreme old age.” (the New York Times)

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