The best states for elderly patient care

As the elderly population in the United States increases and as value-based reimbursement gains momentum, healthcare executives must find new ways to improve the quality of care for seniors while reducing healthcare costs.

Currently, one in seven Americans is age 65 or older, and that number is only going to increase as the rest of the baby boomers move into this demographic. In fact, America’s senior population is poised to double between 2012 and 2050, according to the U.S. Census Bureau.

A recently released report entitled "America's Health Rankings Senior Report: A Call to Action for Individuals and Their Communities" from United Health Foundation, indicates in which states health plans and health executives are encountering the most challenges when caring for seniors. It also sheds light on some noteworthy health-related trends related to the health of the U.S. senior population as a whole.

This is the third edition of the report, which ranks states based on 35 measures that affect senior health, including prescription drug coverage, geriatrician supply, the percentage of elderly adults with a personal healthcare provider, and percentage of seniors who received the flu vaccination.

"The report can give all healthcare professionals a data-driven view of senior health in our country, including how specific behaviors and outcomes differ state-to-state, and how senior health has changed year-to-year nationwide," Rhonda Randall, MD, senior adviser to United Health Foundation and chief medical officer and executive vice president, UnitedHealthcare Retiree Solutions, told Managed Healthcare Executive.

Continue reading to view key takeaways from this year's report, and to see which states ranked as the five best and worst states for senior health.

The key takeaways from this year’s report include some promising trends in senior care, said Randall. "Preventable hospitalizations dropped 8.6 percent, and more seniors are spending their last days in the settings they prefer, with this year’s report showing a 3.1 percent increase in hospice care and a 9.3 percent increase in the number of home healthcare workers."

Perhaps most notably, the report also found that there was a 9% decrease in preventable hospitalizations per 1,000 Medicare beneficiaries, and a 9% decrease in hospital deaths per 100,000 Medicare beneficiaries.

"The most positive finding in this year’s report was that seniors are increasingly getting the right care in the setting of their choice, which is good news not only for senior health but for our healthcare system overall," said Randall. "Preventable hospitalizations are down, hospice care has increased, and both executives trying to implement better care and seniors trying to receive better care are benefitting from this shift."

While progress has been made in some areas of senior health, problems have evolved in others.

These problems include a 15% increase in physical inactivity, with 33.1% of seniors being classified as "inactive." In addition, 37.6% of seniors have four or more chronic conditions, and community support spending per capita has declined by 23.9% the past two years, said Randall.

"America’s Health Rankings Senior Report shows that health goes beyond the clinic doors and extends in to the community," she said. "Physical inactivity is the greatest challenge that the report identifies for today’s seniors. One third of seniors are physically inactive, and as many of us in the healthcare community know, physical inactivity is linked to a number of serious chronic health conditions including heart disease and obesity."

Physical inactivity can also lead to frailty, which can lead to a loss of independence for elderly adults, said Randall. "Losing your independence as you age and needing assistance to perform the basic activities of daily life is for many seniors one of the worst things that can happen," she said. "More people fear losing their independence than they do getting a chronic disease such as diabetes or heart disease because those are perceived as treatable. This year’s report shows both healthcare executives and community leaders that identifying ways of keeping seniors active should be a priority ..."

Next: The Top Five States

#1. Vermont

This year, Vermont tops the list of healthiest states for older adults, according to the report. Its strengths include ready availability of home-delivered meals, high enrollment in the Supplemental Nutrition Assistance Program (SNAP), and low ICU use. Challenges include a high prevalence of chronic drinking, low hospice care use, and a high prevalence of falls.

#2. New Hampshire

With a low percentage of seniors living in poverty, ready availability of home-delivered meals, and high health status, New Hampshire ranks #2. The state's challenges include a high prevalence of activity-limiting arthritis pain, low prescription drug coverage, and low SNAP enrollment.

#3. Minnesota

Minnesota, stands out for high volunteerism, low prevalence of food insecurity, and few poor mental health days. Its challenges include low community-support expenditures, low SNAP enrollment, and a low percentage of seniors with a dedicated provider.

#4. Hawaii

Hawaii stands out for its low prevalence of obesity, low geriatrician shortfall, and low hip fracture rate. Challenges include a high prevalence of underweight seniors, a high prevalence of activity-limiting, arthritis pain, and a high percentage of hospital deaths.

#5. Utah.

Utah is new to the top five this year. Its strengths include a low prevalence of smoking, high volunteerism, and ready availability of home-delivered meals. Challenges include low SNAP enrollment, high geriatrician shortfall, and a low percentage of diabetes management.

Next: The Bottom Five States

#50. Louisiana

At the bottom of the rankings sits Louisiana, which, despite a high prevalence of flu vaccination and home healthcare providers, also has a high prevalence of smoking, obesity, and physical inactivity. Other challenges include a low percentage of seniors who visited a dentist in the past year and a high prevalence of food insecurity.

#49. Mississippi

Mississippi's challenges include low SNAP enrollment, a high geriatrician shortfall, and a low percentage of diabetes management. Still, it has a low prevalence of smoking, high volunteerism, and ready availability of home-delivered meals.

#48. Kentucky

Unlike Mississippi, Kentucky wrestles with a high prevalence of smoking. It's challenges also include a low percentage of dental visits and a high premature death rate. Strengths include a low prevalence of chronic drinking, a low percentage of low-care nursing home residents, and high flu vaccination coverage.

#47. Arkansas

Like Kentucky, Arkansas has a low percentage of dental visits. It also has a high prevalence of food insecurity and a low percentage of able-bodied seniors. Its strengths include a low prevalence of chronic drinking, ready availability of home-delivered meals, and low ICU use

#46. Oklahoma

Rounding out the bottom five, Oklahoma wrestles with a high prevalence of physical inactivity, a high percentage of low-care nursing home residents, and a high hip fracture rate. Its strengths include a low prevalence of activity limiting arthritis pain, high flu vaccination coverage, and low ICU use.