At the same time, declining birth rates and longer life expectancies — half of babies born in 2020 are expected to live past 100 years — pose potential workforce challenges.
Becker’s connected with four health system leaders to explore the challenges this demographic shift presents and how they are preparing to address it.
Caring for older adult patients
Mark Behl, CEO of Fairfield, Calif.-based NorthBay Health, told Becker’s the system is already seeing the effects of this shift.
“The number of retirees is growing by nearly 1% every year, and they now represent a larger portion of our population than ever before,” Mr. Behl said. “This trend brings several challenges, particularly an increased demand for complex medical services and a strain on healthcare resources.”
To address these challenges, NorthBay has invested more than $250 million in an ambulatory network expansion, opening 10 new primary and urgent care centers. These “neighborhood clinics” provide services outside traditional hospital settings, helping older adults access preventive care and chronic disease management closer to home, Mr. Behl said.
“This proactive and strategic expansion will help prevent unnecessary hospital visits, manage chronic conditions more effectively, and give seniors the personalized care they deserve — all while alleviating the strain on hospital resources,” he said.
At Chicago-based Cook County Health, the challenge is twofold: “meeting the needs of a growing and aging patient population, and ensuring we have enough qualified professionals to provide that care,” CEO Erik Mikaitis, MD, told Becker’s.
“At Cook County Health, we are focused on adapting to this shift by building a more sustainable workforce and expanding our capacity to meet the growing demands for care,” Dr. Mikaitis said. “This includes enhancing recruitment efforts and providing ongoing professional development for our current team.”
The system is also investing in cardiology, surgery, oncology and nephrology, service lines expected to see increased demand as patients age.
In Houston, approximately 12% of the city’s population was 65 and older as of the latest data from the U.S. Census Bureau.
“We’ve tried very hard and have been very intentional about how to personalize the care that we provide so that we can truly advance the health of the individual, the population and the community,” Erin Asprec, COO of Houston-based Memorial Hermann Health System, told Becker’s.
For older individuals specifically, Memorial Hermann uses an evidence-based practice called the “4M” framework: What Matters, Medication, Mentation and Mobility. The health system has designed and executed several programs and services, including an acute care for elder unit, or ACE unit, which opened in 2022 at its Southwest Hospital.
“It’s specifically designed to address the challenges that seniors or older adults face when they’re hospitalized,” Ms. Asprec said. “… The multidisciplinary team there consists of individuals who have the expertise, experience, as well as interest in older adults. So the team consists of geriatric-trained nurses, social workers, case managers, dietitians, pharmacists and hospitalists.”
Memorial Hermann also has a Silver Trauma Unit within Memorial Hermann-Texas Medical Center. Ms. Asprec said the unit specializes in recognizing the signs and symptoms of older individuals who may be experiencing setbacks in their recovery from post-traumatic injury.
“[Members of the unit’s staff] really focus on preventing falls, preventing delirium and encouraging early mobility,” she said.
Outside of the health system’s walls, there is a Bone Health and Fragility Fracture Clinic, a partnership between Memorial Hermann and the McGovern Medical School at UTHealth Houston. The clinic addresses metabolic bone disorders, fragility fractures and bone loss through osteoporosis.
“What’s unique about this clinic is that it really streamlines the referral and triage process because we put all the doctors that they need in one clinic,” Ms. Asprec said. “This clinic has endocrinologists, orthopedists, trauma surgeons, as well as physical medicine and rehab physicians.”
Services such as nutritional counseling, vitamin supplementation and guidance on how to manage medications are also provided there.
“What’s amazing about this clinic is that this multidisciplinary team comes together to assess patients as one team,” she said. “They outline preventative strategies so seniors can take better care of themselves. They actively work with the seniors, and they do a great job recognizing any potential complications or complications that could increase morbidity and mortality in seniors.”
Additionally, Memorial Hermann offers home health and hospice services through a joint venture with AccentCare. Ms. Asprec said this partnership has helped Memorial Hermann better attend to transitions of care — particularly in terms of older individuals transitioning from hospital to home. Memorial Hermann has also partnered with SafeRide to provide transportation to low-income older individuals to promote access to care, and works with community organizations in the Houston area to provide wraparound services.
Recruitment and retention strategies
As health systems prepare for an aging workforce and the possibility of many experienced workers retiring simultaneously, they are implementing strategies to recruit, retain and reengage talent.
At Santa Barbara, Calif.-based Cottage Health, succession planning is a key focus, Chief Human Resources Officer Cara Williams told Becker’s.
“To help retain our most experienced workforce and facilitate transfer of knowledge, we have a new program that allows retiring employees to phase into their retirement across two years, and we are creating a robust succession plan across all levels of our organization that focuses on upskilling current employees to continuing advancing their careers with us,” she said.
In addition to Cottage Health’s workforce pipeline partnerships with local middle and high schools, the system recruits through a boomerang campaign to engage high-performing former employees to offer them opportunities to return as staff members or volunteers.
Reimagined benefits are another key strategy, offering new commuting, housing, education, fertility and menopause benefits, Ms. Williams said.
At NorthBay, professional development is a key focus, Mr. Behl said, adding “Through initiatives such as tuition assistance programs for our nurses and other professionals, we are strengthening our team and enhancing our capacity to provide exceptional care — particularly as we work to meet the needs of an aging population.”
Cook County Health is also investing in workforce development. The Provident Scholarship Fund, aimed at supporting students pursuing healthcare careers, has awarded about $3 million to 182 students in the past three years, Dr. Mikaitis said.
At Memorial Hermann, a focus on retention involves staying attuned to what employees want from their respective careers. For instance, an employee who works at the bedside may want to step away from bedside care but remain in healthcare.
“If someone wants to transition into another career, our recruiters and HR specialists sit down and say, ‘OK, these are the skill sets you need.’ Then we actually help them develop those skills to move into another job,” Ms. Asprec said.
“We [also] stay in touch with people who step away from the workforce to raise a family or for other circumstances. Because of that, many people who have raised their kids want to come back, and we are very open to that.”
To boost its own pipeline, Memorial Hermann launched a healthcare high school in 2024. Memorial Hermann and the Aldine Independent School District developed the school, with funding from Bloomberg Philanthropies’ initiative to create high schools in urban and rural communities.
“What’s special about this program is that we helped build the high school, and we worked with them to align their curriculum with our competencies, philosophy and needs,” Ms. Asprec said. “Many of our own staff go and teach at the high school, students do their practicum inside our system and then they’re offered a job at the end.”
Memorial Hermann also has partnered with colleges such as Houston Community College and Purdue Global.
“We align our curriculum, they do their practicums with us and then, because they’ve learned our processes, we give them, obviously, huge opportunities to come work for us afterward, and their onboarding is quick because they’ve already learned in our environment,” Ms. Asprec said.
Key technologies
Health systems are also turning to technology to address workforce shortages and improve care for older patients.
Cook County Health is leveraging technology to allow staff to work at the top of their license and improve care efficiency. The safety-net system’s goal is to further integrate technology for telesitting, remote monitoring and hospital-at-home models.
Memorial Hermann aims to reduce workforce strain while ensuring high-quality care with initiatives such as its Innovation Hub.
“The Innovation Hub has two objectives,” Ms. Aspre said. “The first is to identify the pain points of our patients and our staff and to create solutions to address those pain points. We test them out in an environment that is controlled, and then, if they meet their [key performance indicators] or objectives, we cascade them [within the organization].”
She noted that several projects were derived from the Innovation Hub to support older individuals. This includes a partnership with Zibrio to assess a patient’s fall risk as well as remote monitoring.
“We have a plethora of people that we work with, but at the end of the day, it really helps us help our seniors manage their chronic diseases better, especially those with congestive heart failure,” Ms. Asprec said.
Memorial Hermann also uses Grace, a virtual voice experience platform, for appointment and screening reminders, and has a partnership with Reimagine Care that provides online and home symptom management for cancer patients.
“We’ve seen that technology — and what we’ve done there — really improves patient outcomes,” Ms. Asprec said. “Our providers and patients are more satisfied. It came out of the ED because oncology patients sometimes go to the ED a lot, just because they have so many symptoms.”
Additionally, Memorial Hermann has a partnership with Helix to help with early identification of heart disease as well as women’s health diseases. Ms. Asprec said patients volunteer, and if they have an early identification of particular genes, the health system works with them to put a preventive plan together.
Overall, she acknowledged that health systems across the U.S. face challenges to address shifting demographics.
“The environment never stops being difficult,” Ms. Asprec said. “But I think what’s been helpful to us is really listening to our various populations and designing care around what they need.
“And so we do that for seniors, and we do that for all the other populations as well. That’s really what we’re after — what’s valuable to the patient and the consumer, and what makes the difference in getting them back to where they want to be.”
