AARP Eye Center
The 2024 election season is right around the corner. And while there are many pressing issues weighing on all of our minds right now, affordable, accessible, quality health care tops the list for many – especially for older Americans.
I spend a lot of time thinking about how to get more people the health care they deserve. But the health care field is large, complex, and ever-evolving. So, if like me, you’re in the midst of planning for the year ahead, it’s helpful to have a primer on major areas of interest and momentum in the field.
Here are five trends that I’m watching. Some have emerged recently; others have been growing steadily for some time.
Ongoing Changes in Where Health Care is Delivered
Once upon a time, you went to a doctor’s office for check-ups and were admitted to the hospital if you needed tests or treatment. Today, we have a LOT more options for everyday care, and the list is growing.
CVS added mental health screenings to its free Project Health community-based health screening program.
Walmart is doubling the number of health centers it operates inside its Supercenters.
Costco launched a partnership to provide telehealth services to its members.
Dollar General is working with a mobile clinic operator to bring health care to rural areas.
Across the country, employers and communities are hosting health fairs and pop-up clinics that make it easy for folks to get their blood pressure checked along with other simple tests and screenings.
And thanks to innovations in policy and medical technology, even complex treatments are being delivered more and more on an outpatient basis. Analysis by the Advisory Board projects that more than one-third of knee replacements will eventually be performed in freestanding ambulatory surgery centers, and 30% of inpatient hospital admissions could shift to “Hospital at Home”.
Taken together, these changes make health care more convenient and less expensive.
Unpaid Family Caregivers Being an Integral Part of the Healthcare Delivery System
The shift away from traditional clinical setting also means patients are taking on considerable responsibility for their care . . . and often their loved ones are now critical members of the care team.
In effect, these unpaid family caregivers have become health care providers themselves, making sure medications are taken on time, blood pressure and blood sugar are monitored, special diets are followed and more – often with little or no training.
There are 48 million family caregivers across the country – 10 times the number of paid long-term care workers.
AARP’s research shows that:
- 71% of family caregivers monitor their loved ones' condition so they can adjust care accordingly;
- 65% communicate with health care professionals;
- 58% assist with medical/nursing tasks like injections, tube feedings, and other complex care responsibilities.
Overall, family caregivers provide approximately $600 billion worth of care to their loved ones, making them the backbone of our long-term care system.
It is, therefore, increasingly important for health care institutions, providers and payers to recognize the role these folks are playing and give them the support they need to participate in their loved ones' care with confidence.
Continued Growth of Accountable Care Organizations
Another area where we continue to see movement – albeit more slowly -- is the ongoing growth of Accountable Care Organizations (ACOs). This year, more than 13 million Medicare beneficiaries receive care from providers affiliated with ACOs, up from 11 million in 2021.
These groups of hospitals, doctors and other health providers work together to coordinate each patient’s care across different settings with the goals of helping people stay healthy, improving the care experience, and reducing costs.
For older adults and their loved ones, this approach can make it easier to navigate the health care system, reducing unnecessary tests, appointments or visits to the emergency room and ensuring that relevant information is shared without a lot of red tape. Read more about ACOs here.
The Centers for Medicare & Medicaid Services (CMS) has set a goal of having all Medicare enrollees be part of a coordinated care arrangement by 2030.
Technological Innovations are Changing the Game
There’s no question that technology has and will continue to have a tremendous impact on how medicine is practiced and delivered, as well as how people interact with the health system.
Surgeons are using robots and augmented reality to make operations less invasive with fewer complications. 3D printers can create medical devices customized for individual patients. Artificial intelligence can be a powerful tool for diagnosing conditions and identifying effective treatments. The will continue to grow, presenting both opportunities and challenges, particularly when it comes to AI. Oversight and thoughtful planning will be essential to ensure that it is used appropriately and that human decisionmakers are responsible for patient care.
On the consumer side of things, the COVID-19 pandemic accelerated people’s comfort level with and demand for telehealth solutions in a way that will have a lasting impact. And, a lot more people now know how to make appointments for things like vaccinations using websites and apps.
We’re also seeing increased interest in solutions that help people be more in charge of their own health. Wearable medical devices have been gaining traction in recent years. Beyond activity trackers and step counters, the new wave of wearables can take EKGs, measure blood pressure and oxygen levels, monitor glucose, and more – and then send real-time data to your doctor to make more informed decisions about your care.
The Need to Build the Bench of Paid Care Workers
But, technology will never fully replace a human caregiver. While there are 10 times as many family caregivers as paid long-term care workers in the U.S., having a robust direct care workforce is absolutely critical and will only because more important in the years ahead.
Today, there are 55 million Americans age 65 and older, and 48 million family caregivers. By 2040, 65+ population will be at least 80 million, so a proportional increase to support them would boost the needed caregiver population to around 70 million.
But, we’re headed into what I call the “caregiver crunch” . . . because of divorce, lower marriage and birth rates, there will actually be FEWER immediate family members around to take on a caregiving role.
Meanwhile, over the next eight years, an estimated 1 million new direct care jobs will be created and millions more positions will need to be filled as these workers retire or take different kinds of jobs. There is a lot of work to do to attract and retain people for these paid caregiver roles that provide vital support to older Americans and their families, including better pay, training and working conditions .
The Common Thread for the Future
These trends point toward an overall direction of decentralized care, enabled by technology, and delivered on demand. There certainly are upsides in terms of convenience and potentially cost. But, one that is clear to me when you drill down and think about what this means for real people is that it often takes a TEAM to make it all work. Medical professionals, patients, unpaid family caregivers, and paid direct care workers are all essential players.