The reset: An aging patient surge is coming

An aging patient surge is coming

By 2035, patients 65 and older will account for most of the growth in hospital use. That demographic reality is already shaping how health systems think about scheduling, staffing and which services to offer where. Medical Economics asked Shannon Sims, M.D., Ph.D., FAMIA, chief product officer at Vizient, and Matthew Bates, M.P.H., managing director at Kaufman Hall, how physician practices should be positioning themselves now.

Bates started with the shift toward lower-acuity settings — procedures moving from hospitals to ambulatory surgery centers, care moving into the home or virtual channel. That's good, he said, but it leaves a harder problem: The older patients who do end up in the hospital are increasingly arriving with multiple chronic conditions that don't respond well to siloed specialty care. A patient managing diabetes, a cardiac condition and a new cancer diagnosis needs those treatments coordinated, not run in parallel.

"We cannot treat them as three independent diseases, because the drugs and treatments bump up against each other," Bates said. Working out who serves as the "quarterback" for that kind of complexity is something health care hasn't fully figured out yet.

Sims reframed the whole challenge around a single constraint. Invoking the business adage that culture eats strategy for breakfast, he updated it for health care: "Access eats whatever strategy you have."

Getting older patients in, moving them through efficiently and transitioning them out to appropriate postacute settings is the operational problem that has to be solved before anything else works. The evidence is in what health system leaders are actually worried about.

Coming out of the pandemic, staffing dominated every conversation. Now, Sims said, access has taken its place as the top concern — and solving it means embracing technology, advanced practice providers and other models that most practices haven't fully committed to yet.