About a third of the $4.4 trillion spent last year on healthcare in the United States was from the people aged more than 65 years, “and the estimate is that this group will represent half of all healthcare spending in the US in the next 10 years, which is a huge number and tells us that most of this care is not going to be done in hospitals,” David Friend, MD, MBS, Midwest healthcare leader for Marcum LLP, said Tuesday during a webinar sponsored by the accounting and advisory services firm.
To that point, he said, care outside of the hospital, “is just going to continue to grow and grow. And that’s why we think there’s going to be so much opportunity, frankly, to improve the system.”
Currently, Friend said, approximately a million and half assisted living and independent living beds exist in the country. Add memory care and skilled nursing into the mix, he said, brings the total to approximately 3.2 million beds.
“But think about it: There are 60 million people who are potentially going to need care,” he said. “So even if every single bed is filled, even if all 3.2 million of those beds are filled, that means 90% to 95% of people, if they need care, are going to need to be cared for at home, because there simply is not enough capacity to care for them.”
For example, Friend said, approximately 6 million to 7 million people in the United States are living with dementia, but there are only approximately 300,000 memory unit beds. About 95% of people living with dementia are being cared for at home by caregivers who typically are their family members, he said.
Friend noted that the government plans to test a new reimbursement program designed to help caregivers of people living with dementia. As McKnight’s Senior Living and its sister publications reported, the Centers for Medicare & Medicaid Services last week announced the Guiding an Improved Dementia Experience, or GUIDE, model. The goal is to improve the lives of people living with dementia and lower the strain on their family caregivers. The program also eyes better care coordination so that people can stay in their homes for as long as possible. It includes caregiver education and support, as well as respite services for when caregivers need a break.
Looking to the future, Friend said, “at home” might not be a traditional home; rather, it could be an assisted living community or even a skilled nursing facility. (Some assisted living communities already provide home- and community-based services to residents through state Medicaid waivers.)
David Mustin, MBA, vice president of strategic IT consulting at Marcum, said that with the challenge of not having enough staff members and not enough beds available in some nursing facilities, people are looking at alternative settings, such as at-home care or living in an assisted living or independent living community.
An issue with those alternatives, however, according to Mustin, is that an older adult won’t have the around-the-clock monitoring that he or she would have in a nursing facility. Many senior living communities are not designed to care for, or permitted by state law to care for, seriously ill individuals.
“So the question becomes, how do you do early monitoring and early intervention when issues do arise? I think that’s where new and alternative technologies are really arising to help monitor and track and look for issues that may be occurring in the patient populations,” Mustin said.
“And as you think about even simple things like wearables, things like Apple Watches and other technology, you have the opportunity to identify issues and problems early on and augment the capabilities of staff or family members to identify what problems are occurring,” he added.
Competing in the marketplace is evolving.
“There are some healthcare providers today that will be in a very different kind of business 10 years from now than they are today,” said Matt Murer, JD, healthcare, public policy and government investigations department chair at Polsinelli.
The future, he added, will see greater collaboration and joint ventures in the senior living and post-acute care space.
For additional coverage of this webinar, see McKnight’s Long-Term Care News.
