Project Summary
CAPABLE (Community Aging in Place—Advancing Better Living for Elders) is a program developed by researchers at the Johns Hopkins University School of Nursing to improve quality of life, improve functional ability, reduce hospitalizations, and reduce nursing home admissions in older adults. The American Rescue Plan Act of 2021 (ARPA) dollars were used by the Colorado Department of Health Care Policy & Financing (HCPF) to pilot lowering the age eligibility to eighteen. The Colorado Lab is evaluating how well CAPABLE works in a community-based setting for adults across the lifespan.
The evaluation is mixed methods: pre-post test client data and qualitative interviews and focus groups with providers at two sites. The primary purpose of this evaluation is to inform recommendations for making CAPABLE a long-term Medicaid benefit in Colorado. The evaluation will capture lessons learned from the Colorado CAPABLE pilot to inform potential future program expansion and evaluation. The final report will be available in fall 2024.
Steps to Building Evidence
The CAPABLE evaluation follows Step 2 on the Steps to Building Evidence (fidelity and implementation monitoring) and Step 3 (pre-post outcomes analysis). Previous studies have validated CAPABLE’s efficacy in improving the lives of participants and has been shown to significantly reduce medical costs. This pilot expands eligibility criteria so we focused the evaluation on implementation and monitoring outcomes to validate CAPABLE’s efficacy in Colorado and with a more diverse population.
Summary of Findings
CAPABLE was shown to produce positive and strong statistically significant outcomes for a wide range of Health First members, regardless of age and location. Its successful implementation across the state appears feasible from a financial and operational perspective, and its distinct interdisciplinary model promotes greater efficiency and accountability than the current Home Modification benefit. With additional targeted messaging and evaluation, the CAPABLE model could serve as the foundation for a two-tiered Home Modification Benefit in Colorado.
Actionability
HCPF developed a theory of change, in partnership with the Colorado Lab, to guide their ARPA investments and associated evaluations. Their “North Star” is help people build a life that is meaningful to them in a safe and supportive environment. HCPF want to know how CAPABLE works in a community-based setting for adults across the lifespan. The evaluation will inform recommendations to move from an ARPA resourced pilot to making CAPABLE a long-term Medicaid benefit.
Get Involved
For more information about working with the Colorado Lab, see Government and Community Partnerships or Research Partnerships.