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Creating the Future: Changing Aging Services AHCA Convention October 8, 2007. Steve Chies, SVP, LTC Operations, Benedictine Health Services Jeff Wilson, CEO, Liberty Healthcare LTC Group, North Carolina Loren Coleman, Asst. Commissioner, Dept. of Human Services, MN
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Steve Chies, SVP, LTC Operations, Benedictine Health Services
Jeff Wilson, CEO, Liberty Healthcare LTC Group, North Carolina
Loren Coleman, Asst. Commissioner, Dept. of Human Services, MN
Nancy Rehkamp, Principal. LarsonAllen
John Richter, CPA, National Health Care Principal, LarsonAllen.
The single biggest driver in aging services expansion will be the population growth of those eligible for Medicare coverage, particularly the 85+ cohort. 85+ adults use health resources approximately 40% more than other Medicare beneficiaries. The growing understanding of the changing family structure and dynamics also leads CMS to believe future elders will rely on formal care more frequently.
The rapid growth in older adults with significantly lower growth in younger populations will create challenges to informal caregiving, workforce availability and other issues.
Source: US Census Bureau Statistics accessed 1/07
SNFs today and in the future primarily serve Mom.
Women are more likely to be poor and alone in their advancing year.
Men are expected to live longer and be single more often than today. It is expected that single older men will also have fewer financial resources than today.
Source: CMS Chart Book; 1/31/07
Percentage of Family Caregiving:
1988 1995 2001 2010 2030
Caregiver Ratio 7.51 6.78 4.34
Elderly Dependency Ratio 4.75 4.61 2.76
The Caregiver Ratio is a comparison of the number of elders 85 + to women aged 45 to 64. The Elderly Dependency Ratio is the number of elders 65+ compared to workers aged 20 to 64. The lower the ratio the fewer the number of caregivers or workers. The expected decline in available caregivers and available workers will be over 40%
As an example we find in Minnesota each 1% drop in family care giving requires approximately $30M in additional public funds for Minnesota.
Source: National Caregivers Association & US Census Population Projections by Age & Sex
Hospital utilization by Medicare beneficiaries is not uniform across the country.
This variance can also be seen in the discharge rate to SNFs. Nationally about 16% of acute Medicare patients use SNFs post acute.
The range in percent discharged to SNFs, however, is estimated to be 8% to 35%. If the use of swing beds by small rural hospitals is included the numbers could be higher.
Source: Kaiser Family Foundation, State Health Facts based on 2003 data accessed via the internet June 2007.
Medicare discharges per 1000 grow significantly with age. The rapid growth in the population 85 and older may result in higher numbers of Medicare admissions and more individuals requiring post-acute services. Nationally, 16.5% of 65+ use Part A SNF services following an acute stay, but this goes up to almost 35% for those 85+.Source: The Chart Book 2007, CDC published 1/07
Residents’ needs are changing significantly. Many more residents will be shorter stays and will have higher clinical care needs. This will result in facility changes, different equipment needs, and specialization. It may result in new competitors and changes in market thinking.
The residents that stay one year or less will probably represent about 85% to 90% of all resident admissions by 2030. These will be residents transitioning from acute care to home.
Strategically Using the Imperative Demand Model
A vision for elder care which:
“The problems that exist in the world today cannot be solved by the level of thinking that created them.”
Diversify the services offered to meet the changing needs and demands by the communities served.
Renovate or replace older buildings.
Recruitment and Retention
Foreign Worker Recruitment
Electronic Medical Records