From 1998 to 2000, a consortium of four nonprofit provider organizations worked to design a community-based program at low-income housing sites in Baltimore that would provide medical and social services to elderly residents who were not yet frail. Consortium members included:
- Baltimore Medical System
- Catholic Charities
- Johns Hopkins Geriatric Center
- Sinai Health System
- Based on findings from focus groups and other research, the project began to offer a set of services—companionship, housekeeping and ridesharing—to seniors living in their own homes, but a variety of marketing efforts yielded very little interest.
- Project staff then adopted a fall-prevention program that its physicians could recommend to patients, sending a service coordinator to seniors' homes to recommend cost-effective changes that would prevent falls.
- The project director participated in a state feasibility study for a new version of a Social HMO—a Medicare HMO which also includes long-term care services in the home—but the collapsing Medicare managed care market made a demonstration of this concept unfeasible.