June 9, 2020             By  Barb Powlowsky

Improving Care for Senior Populations

In Part 6 of our series on how COVID-19 will impact the US healthcare system, Commonwealth Health Advisors explores the emerging trends that will impact how we care for our senior population.  The Medicare population is estimated to grow by 30% over the next ten years making our senior population a substantial concern of the US healthcare system. Changes in FDA, Medicare and other healthcare regulations are being adapted to COVID circumstances, reducing the evaluation ‘rigor’ or red tape and opening the door for some speedy change. Some of these changes may become permanent and advance quality care for an aging population. Others will impact where senior care takes place, where seniors live, and how senior recreation and social programs move forward.  How will we balance senior healthcare and safety with the ability to live a full, robust life? What should executives ask themselves to best position their organizations to meet these changes?

Demand for in-home services for seniors will expand.

Over 5 million people in the U.S. currently receive paid home care – including the frail elderly as well as those with disabilities.  The swelling senior population will drive this number up as will the need to care for seniors who are infected with COVID. We expect other factors, including consumer choice, will fuel this trend further.

Will aversions to visiting a provider office or hospital continue as a consumer preference among our senior population post-COVID? To what degree?

In-home personal care aides are in short supply and at risk themselves.

Pre-COVID, personal care aides were already in short supply. Although the need for these careworkers is high, the hours are long and the pay is traditionally less than $15 per hour.  Now, in this time of COVID, the home care workforce sees multiple high-risk seniors daily, exposing themselves and their patients to higher levels of COVID infection risk.  As a result, there are less individuals in the field willing to continue providing care.

How will the increasing demand for in-home services be met?  How will seniors be supported medically, socially and with basic daily living assistance as they strive to age in place?  How will the shortage of in-home care workers be solved? Which businesses will figure out the right recipe for success in this space?

Anti-isolation programs for seniors will become more prevalent.

The COVID-19 pandemic has triggered a new level of social isolation for our senior population.  Senior centers and day care programs are closed, senior living facilities are not allowing visitors, and seniors are strongly discouraged from all social interactions due to the risks of infection. Efforts to keep seniors safe are forcing the elderly to independently quarantine, exacerbating health issues and piling on mental health issues including depression and loneliness.  It is well understood that social isolation has been associated with increased risk for chronic conditions and has been linked to increases in emergency department visits, hospitalizations, and nursing home placements.

Much can be done to combat isolation, including the increased use of technology solutions.  Seniors are being supported in the set up and use of tech solutions rapidly, driving further adoption into the population.

What types of virtual patient engagement will be introduced and emerge as the winners to help seniors avert or manage depression onset by isolation? Will it be digital? Will it be a service? Will it be electronic toy pets? Amazon Echo? Which organizations will take the lead? Payers? Providers?

Care for seniors in residential facilities will change.

More than 1.7 million people live in long-term care facilities, representing our most vulnerable citizens. Approximately one million reside in assisted living facilities, a number which is expected to double by 2030. During the COVID-19 pandemic none of these residents are able to receive visitors or leave their facility. AARP is sponsoring legislation to require nursing homes to facilitate communication between residents and family. Traditionally, technology for seniors has been limited at most senior living facilities. A permanent shift toward more digital communication and interaction between residents of care facilities and their loved ones may be prompted by the pandemic.

What will this mean for caregivers who may need to support this type of communication? Which companies are positioned to be the big winners to fill this critical and growing need?

Solutions for seniors living with chronic illnesses will evolve.

Over 80% of seniors over the age of 65 live with two or more chronic conditions. With 75% of all healthcare spending being attributed to the treatment of chronic conditions, the senior population accounts for much of this spend. COVID-19 has necessitated some short-term changes to the way chronic treatment care is provided. At the same time, Medicare has opened the reimbursement door for remote patient support (telehealth and RPM).  These factors and more will have a significant impact on the evolution of care for seniors with chronic illness.

What role will remote patient monitoring and telemedicine play? How will seniors be digitally connected to the social services that surround them? How will their care team be virtually connected to optimize care for this growing frail and elderly population? Will “remote emergency room” businesses grow more quickly? Will other important services become more easily integrated (e.g., grocery delivery)?

As healthcare executives consider the many questions that will surface during and after this pandemic, Commonwealth Health Advisors is working with companies to figure out the answers.  We look forward to the opportunity to apply critical thinking, strategic direction and actionable plans to organizations seeking help re-imagining how this pandemic will affect their future, growth and profitability.