With the “silver tsunami” well on its way to landfall, America’s health institutions are preparing like never before to care for an aging population.
The U.S. Census Bureau reports that by the year 2050, approximately 50 million people age 75 or older will be living in the United States. Approximately 80 percent of these older adults will have at least one chronic disease, and 77 percent will have at least two. To provide effective patient-centered care for this population, we need to work now to develop systems and infrastructures that will be both sustainable and in line with individual patient goals.
A critical factor in designing holistic care models for aging, chronically ill patients will be the effective use of interdisciplinary care teams—within practices and across organizations—that offer a broad array of expertise, with all members providing integrated care to the patient. To encourage the development of such integrated team-based systems, it is necessary to move from payment models that compensate for the volume of care provided to those that compensate for the value of care.
Technology advancements will continue to improve our ability to bring diagnostic and therapeutic interventions into communities and homes. Tools such as patient portals and electronic health records have paved the way for high level communication and coordination of services, also allowing the quick relay of information to geographically dispersed caregivers, family, and support systems.
New technology, combined with the increasing patient preference to age in place, means that home-based medical care will continue to gain traction across the U.S., even though no governmental payment system yet exists to make it a sustainable model of care. Demonstration projects such as Independence at Home, and studies like Hospital-at-Home, show that when medical care is delivered in the home, there is potential for high quality care, a better patient and caregiver experience, and cost savings.
To sustain quality care, we need to build capacity for a sufficient clinical and nonclinical workforce specifically qualified to provide this care. This includes the role of the homecare worker, which is projected to be the largest single health-care occupation by 2030.
Lastly, clinicians will need to ask the right questions to discover patients’ goals for care. Doing so will help guide all decisionmaking to ensure that care is aligned with what is most important to patients throughout the natural course of their lives.
Working in interdisciplinary teams, focusing on our patients’ values, and developing systems to provide the right care—in the right place, at the right time—will put our patients first, mitigate costly and unwanted interventions, and allow us to develop a system that delivers the best possible health care to our aging population.
Rebecca Ramsay, MPH, BSN
Chief Executive Officer