In 2008, the Center for Advancing Health (CFAH) was charged by The Atlantic Philanthropies, US Aging Program to identify a program of specific strategies and interventions that could support disadvantaged elderly people in becoming active participants in their health care. 

People benefit most from the health care available to them when they participate actively and knowledgeably in it. The stakes of passivity are considerable: there is greater potential for patient and provider error and poor adherence to treatment, both of which lead to poorer health outcomes. The inefficient use of health care resources is costly to individuals, clinicians, health plans and payers.  It has been documented that people who are healthier, more educated and wealthier are more likely to be able to assume this new role as active participants in their health care. The converse is also likely that those who do not participate — for whatever reason — will benefit less.

To identify solutions, CFAH reviewed the scientific and gray literature, surveyed current government and non-profit activities and consulted hundreds of stakeholders and experts with relevant interests. Some of the results of these efforts include:

  • Engagement Behavior Framework, which identifies the specific behaviors that constitute “engagement” in health care;

  • A Blueprint: that presents a vision of what the country would look like if older people and their caregivers were fully engaged in their health care and identifies the main requirements for changing the social norms surrounding greater participation in care;

  • A series of proposals created for Atlantic Philanthropies describing a range of actions that could be taken to ensure that all -- particularly older, disadvantaged -- people have the opportunity to engage in their health and health care to the extent they are willing and able.

The proposals developed for Atlantic Philanthropies are below: