Tuesday, February 15, 2011

The Boomer Conundrum

That ache in my knee is back. I can't find my glasses even though I must have been wearing them when I got to the office and I haven't left my desk since I sat down. And no matter how long I stood in front of the mirror this morning brushing madly away, I got absolutely no cooperation from my hair. Either of them.

This whole aging thing is not the laugh riot I had been led to expect.

So I was already grumpier than usual when I pressed my nose to the computer screen a little while ago, squinted at my e-mail and found yet another study delineating how many chronic illnesses I—as a certified member of the baby boom generation—can expect to come down with over the next decade or so. Two, if I'm lucky. More, if I'm less so. Ah, the golden years beckon.

This is not all about me, of course. The number of Americans 55 and older will soar in the next 20 years, hitting 107.6 million by 2030, according to the Census Bureau. And any number of savage beasts are nipping at our heels and other body parts.

According to the American Heart Association, hypertension will climb 9.9 percent by 2030, coronary heart disease 16.6 percent, heart failure 25 percent and stroke 24.9 percent. Some 62 million Americans will suffer from arthritis by 2020, the CDC predicts, and a United HealthGroup study says more than half of Americans will have diabetes or prediabetes by then—though that's largely driven by the obesity epidemic among Xers, Yers and Millennials.

Oh, and there's a cheery little article somewhere around here calling Alzheimer’s "the defining disease of the baby boomer generation." I'll look for it as soon as my glasses turn up, assuming I remember to.

Exactly what this will mean for hospitals is hard to pin down. Everything about health care is changing at such an accelerated pace that just when you think you ought to invest a big chunk of change in some new technology or redesign a wing of rooms to accommodate an influx of a certain patient population, something new in care delivery breaks through and the whole paradigm does a 180.

A case in point: The National Cancer Institute forecasts that as the population ages, the number of Americans with one or another type of that affliction will climb from 13.8 million in 2010 to 18.1 million in 2020. While that might be a clarion call to beef up your oncology services, hospitals should carefully consider where they invest. The consulting firm Sg2 notes that inpatient cancer services will grow by just 9 percent through 2020, compared with 36 percent for outpatient services.

A range of developments will make it possible to provide more cancer services in an ambulatory care setting, Sg2 says:

•Advances in and expanded use of genetic profiling
•Earlier diagnoses
•More regular monitoring following diagnosis
•Targeted therapies to reduce side effects
•Evolving technology such as robotic surgery to simplify procedures
•Improved care coordination among all providers

Many of these big leaps forward will apply to other chronic diseases, as well.

While that's good news for boomers, it raises a lot of questions for hospitals as they position themselves in an ever-more integrated care delivery system.


Wanda Jones, President, NCHI said...

Some additional points about Boomers:

1) Most are still in the private sector, so that it is not Medicare that needs to be feared, it is what Boomers' accumulation of chronic diseases will do to private insurance prices, at a time when private insurers will also have the imact of cost-shift from government patients, if the Medicaid expansions go forward.

2) Boomer doctors will be leaving practice at a time when they are needed to care for other Boomers. What then? We already are dependent on Foreign Medical Graduates to fill in. We should push through reorganization to enlarge physician capability via teams of associated health professionals.

3. The care of Boomers and seniors will have to be reconfigured from acute care to longitudinal care for people with chronic conditions--starting at time of enrollment where risks should be assessed and addressed.

See my paper, "Blueprint for 21st Century American Healthcare System,"
New Century Healthcare Institute, San Francisco, 1/1/11--soon to be an e-White Paper by Payers and Providers (March).

Wanda J. Jones, President, NCHI

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