MediCaring Communities Online Version


This is the online edition of MediCaring Communities: Getting What We Want and Need in Frail Old Age at an Affordable Cost

By Joanne Lynn, MD and The Center for Elder Care and Advanced Illness at Altarum [now the Program to Improve Eldercare]

List Price $9.95 at
Kindle version $3.49
Published June, 2016
© 2016 by Altarum and Dr. Joanne Lynn.
194 pages, 6″ x 9″ (15.24 x 22.86 cm)
ISBN-10: 1481266918

MediCaring Communities book cover

MediCaring Communities book (click cover to view on



Core Component #1: Frail Elders Identified in a Geographic Community

1.1 Who is frail and what characterizes that experience?
1.2 How do people transition into frailty?
1.3 Why organize services for frail people by geographic community?
1.4 Why refer frail elders to a MediCaring service delivery system?
1.5 How could a community system find and offer MediCaring to frail elderly people who would benefit?

Core Component #2: Longitudinal, Comprehensive, Elder-driven Care Plans

‎2.1 What processes are essential in generating good care plans?
2.2 How could the delivery system evaluate and improve the care planning process?
2.3 How could the delivery system use care plans to improve the service supply and quality?

Core Component #3: Medical Care Tailored to Frail Elders

3.1 What are the critical elements of geriatricized medical services?
3.2 How would MediCaring Communities develop the workforce?
3.3 How could MediCaring Communities encourage elders to use clinicians who provide geriatricized medical care?
3.4 What is already known about how to improve medical services for frail elders?

Core Component #4: Integrating Social and Supportive Services

4.1 What are long-term services and supports (LTSS)?
4.2 What are the roles of family caregivers and direct care workers?
4.3 How is eldercare financed now?
4.4 How will a MediCaring service delivery model integrate LTSS and medical services for frail elderly individuals?
4.5 How will a MediCaring Community integrate LTSS and medical services for the local system?

Core Component #5: Oversight and Improvement by a Community Board

5.1. What characteristics will mark a successful Community Board?
5.2 What capabilities and authorities does the Community Board need to have?
5.3 What sorts of organizational arrangements could anchor the Community Board?
5.4 What would a MediCaring Community monitor to guide decision-making?

Core Component #6: Financing with Savings from Medicare

6.1 What is the estimated magnitude of savings from more appropriate medical care for frail elders in a MediCaring Community?
6.2 Will more LTSS also yield reductions in the use of medical care?
6.3 How should savings be allocated and what will be the effects?
6.4 How will the MediCaring Community initiative evolve with the increasing numbers of frail elders?

Chapter 7: Implementation: Start with PACE

7.1 How should we start implementing a MediCaring Communities model? Answer: PACE!
7.2 Which communities should become the first MediCaring Communities?
7.3 What will CMS need to do to make it possible to implement MediCaring Communities?
7.4 What strategies other than PACE can generate a MediCaring Community?
7.5 What could other stakeholders do to help a demonstration of MediCaring Communities to succeed?
7.6 Could social impact bonds or “pay for success” models help with the initial financing?
7.7 After the first set of PACE expansion initiatives, how might MediCaring Communities develop?

Chapter 8: Forging the Will

8.1 How can Americans become more aware of the challenges of frailty in the last phase of life and become familiar with the connections to public policy and historic service delivery arrangements?
8.2 What organizations and interests are likely to support or oppose the endeavor and what strategies might forge a consensus to proceed?

A Final Word

About the Author, Altarum, and The Center for Elder Care and Advanced Illness

Copyright and Credits

Content is provided with a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license (CC BY-NC-SA 4.0, documented at, which authorizes you to share and adapt the material for noncommercial purposes so long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

Cover photograph “A Little Help Needed” © 2015 by Anne Worner, used with permission under Creative Commons license [Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)]. Photo by Anne Worner shows her mother, Solveig Høviskeland, and uncle, Torjus Tvedt.

Book design by Les Morgan.
Createspace First Edition (June 2016)
ISBN-13: 978-1481266918
ISBN-10: 1481266918

“You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”
—R.Buckminster Fuller

This is the online edition of MediCaring Communities

MediCaring Communities: Getting What We Want and Need in Frail Old Age at an Affordable Cost
List Price $9.95 at
Kindle version $3.49
Published June, 2016
194 pages, 6″ x 9″ (15.24 x 22.86 cm)
ISBN-10: 1481266918

MediCaring Communities book cover

Click cover for

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