Articles-Thought Leadership Five Factors Changing the Delivery of Care | Page 2

Not so long ago, hospitals built relationships with
nursing homes to achieve inpatient growth objectives.
The hospital business development staff regularly
called on nursing home administrators and medical
directors in pursuit of becoming the hospital of choice
for their residents. All of this was done in the name of
growing inpatient volume. How times have changed!
Today, these relationships are more important than
ever, but for very different reasons. The entire care
continuum, from home health to skilled nursing
facilities (SNFs), plays a critical role in controlling
healthcare costs and avoiding hospital admissions.
This healthcare continuum includes rehabilitation or
palliative services that a patient receives after, or in
some cases instead of, a stay in an acute care hospital.
Non-hospital services are provided in a variety of
settings, including skilled nursing, inpatient
rehabilitation, long-term acute care, hospice, senior
care housing, non-medical home care, adult day care,
assisted living, continuing care retirement
communities, and home health.
The demand for senior living continues to rise as the
senior population grows at substantial rates. By 2020,
the United States Census Bureau projects a
population of 56 million seniors, with 74 million by
2030. Seniors become eligible for Medicare at a rate
of 10,000 per day.
Seniors Aren’t What They Used to Be
With the rise of consumerism, younger seniors have
higher expectations and are more likely to consider
price in their healthcare decision-making. In recent
remarks, Secretary of Health and Human Services Alex
Azar discussed the next generation of older Americans.
“They have much more experience interacting with
healthcare technology [than older seniors]. We’ve
probably all been impressed by an older relative who’s
mastered Google Photos or Skyping with an iPad, but
think about the next generation of older Americans:
They’ll have mastered technology much earlier in their
lives.” Seniors already use patient portals and online
scheduling, and they view the Internet as an instant
source of medical information.
Oxford Economics, in a briefing paper for AARP,
claims that longer lifespans are “upending conventional
wisdom about how aging affects the overall U.S.
economy and the country. Rather than lengthening
extreme old age, the 30 years added to lifespans in
the 20th century have resulted in a longer middle
age—extending the period when workers are at their
most productive and creative, and representing a
major, often untapped resource.”
According to the National Investment Center for
Senior Housing & Care, nursing home occupancy
declined from 86% in 2012 to 82% in Q1 2018. Length
of stay is also declining. Downward pressure is
exerted by the value-based payment system (VBP),
risk-based health plans, and consumers’ preference for
alternate healthcare delivery channels, such as
telemedicine and home health.
As a result, care across the continuum must evolve—
adapting services to changing needs and technology,
and developing new vehicles for care delivery. Several
factors will spur this evolution:
1. More partnerships between acute and
care continuum providers
2. Value-based payment
3. Changing payer models
4. Medicalization of senior living
5. The internet of caring things
Nursing home occupancy declined from 86% in 2012 to 82% in Q1
2018. Length of stay is also declining. Downward pressure is exerted
by the value-based payment system (VBP), risk-based health
plans, and consumers’ preference for alternate healthcare
delivery channels, such as telemedicine and home health.
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