Article

Baby boomers – Effective population health management and impacts on care

Pulse Newsletter

June 15, 2017
| United States

The approximately 78 million American baby boomers are causing disruption in health care. As three million of them hit retirement age every year, they will continue to require health care services for decades to come. Not all baby boomers are old enough for Medicare benefits. Providers and payors must effectively manage the health of this population that uses more resources per person than past generations. They will have to address care across all settings, including hospitals, ambulatory care, aging services, home health and telehealth.

Keep in mind “members” of any generation are all different, and not all persons in a “population” are motivated by the same events and subjectivities the public may use when referring to boomers, Generation X, Generation Y, etc.

Total U.S. population by age and generation

Total U.S. population by age and generation

Source: https://knoema.com/infographics/egyydzc/us-population-by-age-and-generation

The Centers for Disease Control and Prevention (CDC) shared that Americans are living longer than at any other time. A recent study (October 2016) by the Society of Actuaries provided a “best guess” that the average 65-year-old man should die a few months short of his 86th birthday and a woman at 88. But researchers have also found that despite this improvement in life expectancy the boomers are less healthy than previous generations. CDC data has seen a continuous increase in chronic health conditions since 2012 in this age group. These conditions include cancer, heart disease, hypertension, dementia, arthritis, depression, obesity and diabetes. This all combines to place further pressures on our fragile health systems.

Older Population Growth 1960-2050

Older Population Growth 1960-2050

Source: Healthcare Malpractice Claims 2016 Update — www.AIG.com

Many feel that, just like children have specialists (pediatricians), older people should have access to professionals trained in caring for them for the same reasons. This does not mean that every practitioner must be a gerontologist but at a minimum should have the competencies to address the unique health care needs of an aging, older population. At the same time boomers are transitioning in their lives, so are a significant number of health care providers, including physicians and nurses. Demand exceeds supply in an already stressed care continuum. Baby boomers will lead the advancement of alternative methods for monitoring health and providing care that will allow improvement in health management of generations to follow.

What other factors are impacting baby boomers?

Studies continue to show that this generation is less well-off financially. This includes preparedness for retirement and how they will access and pay for health care during this transition. What are some of the contributing factors?

The 2008 recession negatively impacted boomers:

  • Many lost money or could not relocate because of changes in real estate values
    • Upside down on mortgages
    • Lost equity and foreclosures
    • Parents of boomers with real estate also affected
  • As companies “right sized,” many boomers found themselves un- or under-employed
    • This impacted saving and retirement portfolios
  • Many boomers are supporting others
    • Their own children (non-adult, adults living away and adults living with them)
    • Grandchildren support or raising them
    • Aged parents support or living with them

What can be done?

Health care is often costly, fraught with quality issues and does not always meet the expectations of payors and users. Innovative care delivery models that engage the patient, caregivers, clinicians and care coordinators in a collaborative structure using assessment, option discussions, an understanding of costs and benefits and goal achievement support must be in place to successfully manage the baby boomer population. What should be considered?

  • Improving engagement in wellness and prevention efforts
  • Reconfirming adherence to medications and medical advice
  • Patient and/or care provider assessment for communication and comprehension barriers
  • Managing chronic conditions and disabilities
  • Reducing unnecessary test and procedures — while differentiating the message from denial of care
  • Evaluate the benefits of offering a geriatric emergency department
  • Many boomers are supporting others
  • Better managing advanced or terminal illness and improving aging in place and end of life decision making
  • Health care providers should be augmenting their elder care medical knowledge and skill sets
  • Providers need to evaluate their own workforce staffing to meet demand and achieve access
    • Health care providers are experiencing their own crisis with an extremely large number of nurses, physicians and other clinicians exiting the workforce at the same time baby boomers are placing a substantial demand for access (remember not all baby boomers are old enough for Medicare)

Aging population and professional liability claims

In their 2016 “Healthcare Malpractice Claims” update, AIG devoted a section to “The Graying of America and the Impact of Elder Care.” Also included were findings from elder care claims resolved by AIG between January 2012 and June of 2016. Claim types:

Claim types

Claim types

The United States cannot afford to ignore how baby boomers are impacting health care. We need care delivery and payment models that provide safe and cost efficient health care and that will address access for the staggering numbers of aging boomers who have or will develop very complex care needs. Providers and payors also must realize that with this demand from a specific “at-risk” population, they also must assess their increased financial and liability exposures and impacts to their strategic plan.