The Senior Healthcare Crisis is the result of an exploding senior population, limited income, deteriorating health, massive Medicare confusion and healthcare providers struggling to get paid. And, the arrival of COVID-19 is fanning the flames.
Exploding Senior Population
Pew Research reports that the Baby Boomer generation peaked at 78.8 million during 1999 and, according to AARP, “. . . 10,000 baby boomers are turning 65 every single day, a trend that is expected to continue into the 2030s.”
The majority of America’s seniors are poor as documented by an April, 2017 Kaiser Family Foundation report titled Income and Assets of Medicare Beneficiaries, 2016-2035. The report indicates that, during 2016, half of all Medicare beneficiaries had an annual income of less than $26,200 and one-quarter had annual incomes below $15,250, savings of less than $14,550 and less than $7,350 in home equity. Twenty-four percent had no home equity at all.
As seniors age, their need for affordable healthcare increases.
The National Council on Aging reports that:
- Approximately 80% of older adults have at least one chronic disease and 77% have at least two.
- Diabetes affects 12.2 million Americans aged 60+, or 23% of the older population.
- 90% of Americans aged 55+ are at risk for hypertension, or high blood pressure.
CMS.gov, the Federal Medicare website, reports that there is a strong relationship between poverty and the health of older adults. “Among Medicare beneficiaries with incomes below the federal poverty level (around $12,000 per year for a single person), 38.7% spend over one-fifth of their annual income on premiums and out-of-pocket medical expenses.”
The RAND Corporation study Assessing the Care of Vulnerable Elders, conducted in collaboration with Pfizer, Inc., made a comprehensive assessment of healthcare quality provided to the vulnerable elderly. The key finding was that vulnerable elderly receive (only) about half of the care that is recommended for them.
Massive Medicare Confusion
Most seniors find taking advantage of Medicare and Medicaid benefits extremely confusing:
- In October 2018, Weiss Ratings (a consumer research and advisory service) published a report titled Over 50% of Seniors Say the Medicare Process is Confusing.
- A July 2017 article in the Huffington Post observed that “Medicaid is the nation’s single largest insurance provider, yet millions of Americans are seemingly unaware of what it does and who it serves.”
- An American Society on Aging report (2014) indicated that, among the 20 million Medicare beneficiaries with incomes below 200% of the Federal Poverty Level, more than half do not receive any financial assistance through Medicaid.
Healthcare Providers Are
Struggling To Get Paid
Many healthcare providers, who serve under insured and uninsured patients have a critical need to increase and accelerate Medicaid and Medicare Advantage revenue.
- The Health Inc. article Rethinking Rural Health Solutions To Save Patients And Communities (February 2018), reports that, across the U.S., 673 rural hospitals are at risk of closing, with 210 being at extreme risk. In addition, 60 rural hospitals did close between 2010 and February 2016.
- HealthAffairs (May, 2018) reported that, during 2016, safety net hospitals provided $38.3 billion in uncompensated care.
- Data compiled by Bloomberg, Hospital Bankruptcies Leave Sick and Injured Nowhere to go (1/2020) indicates that at least 30 hospitals entered bankruptcy during 2019.
- A December 2019 article in HEALTHCAREDIVE, Disparities between care in rural, urban areas getting worse notes that “It’s common knowledge that Americans living in rural areas have poorer health outcomes than their urban counterparts. But, despite policy efforts to ameliorate disparities, the gap is not getting any better . . .”
- A July 2018 Encounter Telehealth article, Challenges, Risks and Solutions for Critical Access Hospitals, reports that more than 40% of rural hospitals are operating at a loss because they serve populations with high rates of poverty, less health insurance coverage, and longer travel times to access health care.
The “bottom line” for healthcare providers, who serve vulnerable seniors, is a critical need to increase and accelerate Medicaid revenue.
Two Senior Healthcare Crisis Solutions
ACCESSMed Foundation is working to help vulnerable seniors identify and enroll in their best Medicare and Medicaid, and Medicare Advantage options. Our work focuses on:
- Getting vulnerable seniors enrolled in Medicaid and Medicare Advantage benefits they are entitled to and deserve.
Read more about Medicare and Medicaid Help For Seniors.
- Increasing Medicaid revenue for practitioners.
Read more about how ACCESSMed is working with seniors’ health care providers to increase and accelerate Medicaid revenue.