A healthcare CEO outlines how his organization is sharpening its focus to better serve older adults and adapt to new payment models.
Jeffrey Farber, MD, MBA, FACP, CPE, is President and CEO of The New Jewish Home, a Manhattan-based, not-for-profit health system that provides skilled nursing, rehabilitation, and outpatient services to older adults of all faiths and backgrounds. Before serving in his current role, he was Chief Medical Officer and Senior Vice President of Population Health at Mount Sinai Health System. He is also a member of CMR’s Board of Directors.
In this Q&A, Dr. Farber pinpoints the key focus areas for provider organizations like his in 2025. He also offers a wish list for the industry to help providers deliver better care to older adults.
How are provider organizations like yours evolving to meet the complex medical and behavioral health needs of older adults?
Dr. Farber: We are focusing on more efforts to address prevention and value-based care, including reimbursement models. We’re looking to take on both clinical and financial risk for populations of older adults and move away from the current fee-for-service model. To do that, we’re investing in ways to minimize 30-day rehospitalizations and avoidable emergency room visits, both for our short-term rehab patients and for our long-term care residents.
We are looking at models like the Centers for Medicare and Medicaid Services’ Program for All-Inclusive Care of the Elderly, or PACE, which includes medical and social services. We’ve also recently expanded our adult day care program to evenings and overnight hours, specifically targeting older adults with dementia to address a community need for respite care and to potentially reduce avoidable care escalations.
What are some ways that life science companies can help providers ensure that older adults have access to the medications they need?
Dr. Farber: In geriatrics, we have a mantra: “less is more,” which, when applied to pharma, means that the less complicated a regimen, the better the access, adherence, and outcomes.
The life sciences industry can help by enhancing ease of administration through once-a-day dosing, especially for people with memory impairment or dementia. Offering more medications that can be crushed will also help older adults who develop dysphagia, or swallowing problems. Sublingual medications for anxiety and pain management are also helpful.
Let’s shift gears a bit and talk about technology. How is your organization using technology to improve patient care?
Dr. Farber: One of our exciting research and clinical initiatives is a virtual reality headset program called the Great American Elderverse with Mynd Immersive. The program involves reminiscence therapy augmented by virtual reality. While wearing a headset, a resident who grew up in Puerto Rico 80 years ago could virtually walk around the neighborhood she grew up in. Others could visit a virtual beach or mountains to recuperate and relieve stress. We think this can help with both behavioral manifestations of dementia as well as delirium.
Looking ahead, what do you see as the most significant challenge or opportunity for providers in the next year?
Dr. Farber: The No. 1 challenge and opportunity for us is the CMS Transforming Episode Accountability Model (TEAM), which is coming in January 2026. It’s a mandatory bundle program like the Bundled Payments for Care Improvement and Comprehensive Care for Joint Replacement models. We are working with our hospital partners on our clinical capabilities to be a premier partner to help them care for patients in this value-based initiative.
How can life sciences companies help support providers like you in serving older adults in the year ahead?
Dr. Farber: First, help us prepare for and succeed in value-based programs like CMS TEAM. Pharma and device manufacturers can play a big role in helping providers address total cost of care in episodes for lower extremity joint replacements, hip femur fracture treatments, coronary artery bypass grafts, major bowel procedures, and spinal fusions, which are all included in TEAM.
Second, think about designing studies differently to include total cost of care, including how treatments can reduce ER visits and hospitalizations. That would help all providers who are increasingly clinically and financially responsible for these large populations of patients under value-based care.
Third, include more older adults, especially those with comorbid chronic conditions like dementia, in clinical trials. Many geriatricians are reluctant to start using new medications because of concerns about side effects in older adults, so they wait a few years to get real-world data. I would challenge the industry to address these concerns upfront and let older adults be in the trials. This could go a long way in helping us provide better care to older adults.
