The Affordable Care Act has increased the number of insured older adults as well as the need more services in the realm of assisted living, retirement housing, adult day care, home health services, skilled nursing, intermediate care and other long-term care, according to researchers led by a geriatrician from the Johns Hopkins University School of Medicine. Hospitals that partner with providers of such services will be in a better position to be part of a seamless continuum of care for older adults and participate in accountable care organizations, they add.

In a report published in the journal Medical Care, the investigators say that their Senior Care Services Scale can help researchers and policymakers monitor trends in geriatric health services on a local, regional and national scale.

For the study, lead author Alicia I. Arbaje, M.D., M.P.H., and colleagues analyzed services reported by 4,998 hospitals in 1999 and 4,831 hospitals in 2006 using data from the American Hospital Association Annual Survey of Hospitals. They found a “mismatch” between services that hospitals offered for older adults and services needed by older adults, and they also found that services often were not being offered where older adults needed them.

“The distribution of services we found did not mirror the distribution of where older adults reside in the United States, even before passage of the ACA and the increased access to services it offers,” said lead author Alicia I. Arbaje, M.D., M.P.H.

Researchers found that inpatient and post-acute services for older adults were concentrated in the northern part of the United States and in some metropolitan areas elsewhere. The southwestern, south central and southeastern U.S. had the lowest concentration of services. Those service locations, Arbaje said, do not mirror where older adults live, which includes areas concentrated in the central part of the country, along with large pockets in the southwest and Florida.