The baby boomer generation started turning 65 years old this January, which means an expected 2.8 million boomers will qualify for Medicare in 2011 alone. Hospitals must remain on guard for the implications stemming from an exploding baby boomer population. Here, Ron Wince, president and CEO of Guidon Performance Solutions, a performance management company, shares six thoughts on what concerns hospitals should have and solutions for addressing those concerns.
1. Patient access to care will become an issue. Mr. Wince says the ever-growing baby boomer population poses a challenge for hospitals in regards to patient access to care. According to a USA Today news report, Medicare will surge dramatically from 47 million to 80 million by 2030. The report also shows that while the boomer population is expected to grow at exponential rates, the number of healthcare professionals will only increase each year by less than one percent.
Mr. Wince says hospitals located in areas that attract boomers, such as Arizona and California, should be extra wary. "Baby boomers tend to migrate to warmer climates, so the burden on hospitals will not be shared equally. It's certainly still a national issue, but the impact will be felt most in certain local regions," he says.
2. Hospitals will need to address patients' chronic care needs. While patient access to care is one major problem, another major challenge Mr. Wince says hospitals need to be aware of are the many medical needs of the boomer population. Although boomers may have some acute medical conditions, this patient population is much more likely to be admitted to hospitals with much more chronic conditions, such as cancer, heart conditions or diabetes.
"We can definitely expect to see an influx in patient volume, but we can also expect these patients to have chronic illnesses that can last for decades," Mr. Wince says. "In some cases, some of these patients may even have more than one chronic condition. So hospitals need to start thinking about how to take care of these types of patients."
3. Question of reimbursements remains unanswered. Medicare reimbursements will pose another challenge for hospitals as the baby boomer population continues to grow. According to a Becker's Hospital Review report, as more and more boomers enter the Medicare program, spending will increase approximately 5.8 percent a year. By 2020, Medicare spending will have reached a staggering $929 billion. This raises certain questions about how Medicare reimbursements may be effected, and there is still a great amount of uncertainty around how much hospitals will be reimbursed for many of the services that would be offered to boomers. Mr. Wince says the answer to that question may not come for some time.
4. Cut waste wherever possible. Maintaining a high level of efficiency and streamlining as many processes and procedures are strategies that will help hospitals accomplish two goals. Creating a lean system could help free up physicians and staff members to more quickly tend to patients and could also help hospitals cut waste, thereby saving money and ensuring future profitability. Mr. Wince says he commonly works with many hospitals to see how to help prepare for an increase of colorectal cancer screening cases, which is a preventive service that is now covered, under certain conditions, for all patients over the age 50. To help hospitals face the influx of these cases, hospitals are assigned to look at what steps in the patient-care process can be completely eliminated without compromising quality of care.
"In this exercise, we go from end-to-end, from the time the patient scheduled the screening to the time they are discharged, to see what steps don't add any value in the delivery of that treatment," Mr. Wince says. "What we found for the screening colonoscopy process is that there are numerous redundant steps and forms that we could eliminate altogether."
One aspect of the colonoscopy patient-care process that needed tweaking for lean-ness was call time. Mr. Wince says it took patients an average of 2.5 times to speak to a hospital employee in order to schedule a colonoscopy. "That led to us ask: What can we do so that the patient only has to call one time in order to schedule?" he says.
5. Consider different models of care. In order to address the issue of baby boomer patients, hospitals need to start considering how to become one part of a broader continuum of care. The healthcare industry is buzzing about accountable care organizations and other care delivery models that allow healthcare providers to offer more coordinated and holistic solutions.
"Traditional, hospitals always worried only about their hospital partners, and long-term facilities only worried about their competitors, but now everyone is starting to consider partnering across primary care practices, insurance companies and wellness companies," Mr. Wince says. "Since patients are shared across multiple stages, all these players need to play better together and start building these relationships.
6. Look to hospital associations. Mr. Wince says hospital associations have been making the first steps in making introductions between different healthcare providers. Once the hospital association has made all the proper introductions, the key players — hospitals, vendors, insurers, physician practices and others — can come to the table and start discussing how to make coordinated care a reality.
"One thing we found is that each hospital has a different attitude toward the control within an accountable care organization. Essentially what you have to do is see how a potential relationship could play out," Mr. Wince says. "Who plays what role and when? How should the revenue be shared? The whole process really needs to be carefully thought out."
Learn more about Guidon Performance Solutions.
Concerns
1. Patient access to care will become an issue. Mr. Wince says the ever-growing baby boomer population poses a challenge for hospitals in regards to patient access to care. According to a USA Today news report, Medicare will surge dramatically from 47 million to 80 million by 2030. The report also shows that while the boomer population is expected to grow at exponential rates, the number of healthcare professionals will only increase each year by less than one percent.
Mr. Wince says hospitals located in areas that attract boomers, such as Arizona and California, should be extra wary. "Baby boomers tend to migrate to warmer climates, so the burden on hospitals will not be shared equally. It's certainly still a national issue, but the impact will be felt most in certain local regions," he says.
2. Hospitals will need to address patients' chronic care needs. While patient access to care is one major problem, another major challenge Mr. Wince says hospitals need to be aware of are the many medical needs of the boomer population. Although boomers may have some acute medical conditions, this patient population is much more likely to be admitted to hospitals with much more chronic conditions, such as cancer, heart conditions or diabetes.
"We can definitely expect to see an influx in patient volume, but we can also expect these patients to have chronic illnesses that can last for decades," Mr. Wince says. "In some cases, some of these patients may even have more than one chronic condition. So hospitals need to start thinking about how to take care of these types of patients."
3. Question of reimbursements remains unanswered. Medicare reimbursements will pose another challenge for hospitals as the baby boomer population continues to grow. According to a Becker's Hospital Review report, as more and more boomers enter the Medicare program, spending will increase approximately 5.8 percent a year. By 2020, Medicare spending will have reached a staggering $929 billion. This raises certain questions about how Medicare reimbursements may be effected, and there is still a great amount of uncertainty around how much hospitals will be reimbursed for many of the services that would be offered to boomers. Mr. Wince says the answer to that question may not come for some time.
Solutions
4. Cut waste wherever possible. Maintaining a high level of efficiency and streamlining as many processes and procedures are strategies that will help hospitals accomplish two goals. Creating a lean system could help free up physicians and staff members to more quickly tend to patients and could also help hospitals cut waste, thereby saving money and ensuring future profitability. Mr. Wince says he commonly works with many hospitals to see how to help prepare for an increase of colorectal cancer screening cases, which is a preventive service that is now covered, under certain conditions, for all patients over the age 50. To help hospitals face the influx of these cases, hospitals are assigned to look at what steps in the patient-care process can be completely eliminated without compromising quality of care.
"In this exercise, we go from end-to-end, from the time the patient scheduled the screening to the time they are discharged, to see what steps don't add any value in the delivery of that treatment," Mr. Wince says. "What we found for the screening colonoscopy process is that there are numerous redundant steps and forms that we could eliminate altogether."
One aspect of the colonoscopy patient-care process that needed tweaking for lean-ness was call time. Mr. Wince says it took patients an average of 2.5 times to speak to a hospital employee in order to schedule a colonoscopy. "That led to us ask: What can we do so that the patient only has to call one time in order to schedule?" he says.
5. Consider different models of care. In order to address the issue of baby boomer patients, hospitals need to start considering how to become one part of a broader continuum of care. The healthcare industry is buzzing about accountable care organizations and other care delivery models that allow healthcare providers to offer more coordinated and holistic solutions.
"Traditional, hospitals always worried only about their hospital partners, and long-term facilities only worried about their competitors, but now everyone is starting to consider partnering across primary care practices, insurance companies and wellness companies," Mr. Wince says. "Since patients are shared across multiple stages, all these players need to play better together and start building these relationships.
6. Look to hospital associations. Mr. Wince says hospital associations have been making the first steps in making introductions between different healthcare providers. Once the hospital association has made all the proper introductions, the key players — hospitals, vendors, insurers, physician practices and others — can come to the table and start discussing how to make coordinated care a reality.
"One thing we found is that each hospital has a different attitude toward the control within an accountable care organization. Essentially what you have to do is see how a potential relationship could play out," Mr. Wince says. "Who plays what role and when? How should the revenue be shared? The whole process really needs to be carefully thought out."
Learn more about Guidon Performance Solutions.