Most older adults want to remain in their homes and communities as they age. But for many, everyday challenges — getting in and out of the shower, preparing meals, climbing stairs, or managing chronic health conditions — can make independent living increasingly difficult.
That is why The Harry and Jeanette Weinberg Foundation has continued to invest in Community Aging in Place, Advancing Better Living for Elders, known as CAPABLE. Developed through research at the Johns Hopkins School of Nursing, CAPABLE combines nursing care, occupational therapy, and home repairs or modifications to help older adults improve mobility, manage daily activities, and remain safely at home.
Since 2018, the Foundation has supported CAPABLE as part of its Aging grantmaking strategy. What began as an investment in a promising, evidence-based model has become part of a broader national effort to help more older adults age in place with dignity and independence.
Today, new research, expanded partnerships, and emerging policy opportunities are helping move CAPABLE from a proven intervention toward broader national adoption.
“Most older adults want to remain in the homes and communities they know and love,” said Priscilla Ko, a senior program officer at the Foundation. “CAPABLE helps make that possible.”
New research reinforces CAPABLE’s impact
Recent studies continue to demonstrate CAPABLE’s effectiveness in helping older adults remain independent while also reducing healthcare use and costs.
One study of 205 CAPABLE participants in Maryland found that participants had significantly lower healthcare costs and hospital stays than nonparticipants. Total hospital charges were nearly 30% lower ($47,439 compared with $67,017), while avoidable hospital charges were reduced by more than half ($8,909 compared with $19,251). Overall, participants spent fewer days in the hospital.
A second study in Colorado found that CAPABLE should be recommended as a long-term Medicaid waiver benefit in the state. Participants reported a 24% reduction in difficulty with activities of daily living, such as bathing, dressing, and grooming, and a 21% reduction in difficulty with instrumental activities of daily living, such as shopping, preparing meals, doing laundry, and managing finances.
The Colorado study also found that the average cost of delivering CAPABLE during the pilot was $2,976 per member, with more than 85% of members receiving the intervention for less than $3,500.
Together, these findings add to a growing body of evidence showing that CAPABLE improves quality of life while helping reduce costly healthcare.
But as the evidence continues to build, another question comes into focus: If CAPABLE works, how can more older adults benefit from it?
For years, one of the biggest challenges facing CAPABLE has been sustainability. Researchers, providers, and philanthropic organizations have demonstrated the program’s effectiveness, but expanding access requires partners, infrastructure, and long-term sources of funding.
Several recent developments suggest progress on all three fronts.
National partners are exploring new ways to scale the model
One answer may lie in partnerships with organizations that already have deep roots in communities and the capacity to reach older adults at scale.
Habitat for Humanity implemented CAPABLE in 2018 as part of its Aging in Place strategy. With support from the Weinberg Foundation, Habitat is now expanding implementation of the program across nine additional affiliates and evaluating how the approach can help older adult homeowners through a combination of critical home repairs and healthcare services.
The first phase of that work will include a landscape scan conducted by Harvard’s Joint Center for Housing Studies to assess Habitat’s capacity to deliver high-impact home repair programs. Those findings will then inform a three-year longitudinal study, conducted by Notre Dame’s Lab for Economic Opportunities, of homeowner well-being, intergenerational wealth transfer, community stabilization, and other measures of impact.
A federal policy opportunity could support long-term sustainability
Partnerships can help expand CAPABLE’s reach. Long-term sustainability, however, requires something more: a way to finance the approach at scale. That is why a recent federal policy development could prove especially significant.
The federal Centers for Medicare & Medicaid Services is launching the Long-term Enhanced Accountable Care Organization Design model, known as LEAD, beginning Jan. 1, 2027. Under this voluntary initiative, groups of doctors, hospitals, and other providers — known as Accountable Care Organizations — work together to coordinate care. When they improve quality and reduce costs, they can share in the savings.
One component of LEAD is the Resilience and Independence in a Safe Environment initiative, or RISE. Closely modeled on CAPABLE, RISE is designed to help prevent falls among older adults by combining nursing care, occupational therapy, and home modifications.
“We are pleased that these models prioritize proactive, coordinated, person-directed care for older adults and individuals with complex health needs,” said Tricia Ford, chief operating officer for Care Synergy and the CAPABLE National Center, which engaged policymakers on the CAPABLE model leading to the LEAD-RISE initiative and whose launch was supported by the Foundation. “Through programs like CAPABLE, we see every day how investing in prevention, home-based care, and interdisciplinary support can improve quality of life while helping individuals remain safely and independently in their homes. These initiatives represent an important step toward creating a healthcare system that values prevention, dignity, and whole-person care.”
The initiative also represents an encouraging sign that federal policymakers increasingly recognize the value of preventive, home-based care — a shift that could help create new pathways for CAPABLE and similar approaches to reach more older adults nationwide.
Supporting the future of aging in place
For the Weinberg Foundation, CAPABLE demonstrates how long-term philanthropic investment can help move an effective idea from research to real-world impact. By supporting implementation, evaluation, and policy momentum, the Foundation is helping advance an approach that gives older adults a better chance to remain in the homes and communities they know — with greater safety, independence, and dignity.
“When the Foundation first began supporting CAPABLE, we saw its potential to help older adults remain independent at home,” Ko said. “Today, we’re seeing that potential realized through growing evidence, expanding partnerships, and emerging policy developments that could bring the approach to many more communities nationwide.”
As the population of older adults continues to grow, CAPABLE offers a practical, evidence-based answer to one of the most urgent questions facing families, communities, and health systems: How can more people age in place — and live well — for as long as possible?
