The Medicare Population’s View on Healthcare

In general, seniors feel more empowered and “in charge” when it comes to managing their healthcare and related decisions, according to a new survey.

The 2017 National Health Interview Survey administered by the CDC, found that when asked to rate their overall health, 82% of adults aged 65 to 74 years described it as excellent (18%), very good (32%), or good (32%), according to a recent article in the Washington Post. In contrast, 18% of this age group had a negative perspective, describing their health as fair (14%) or poor (4%).

Among adults age 75 and older, this trend toward positivity is also evident. Seventy-three percent of this group said their health was excellent (12%), very good (28%), or good (33%), while only 27% gave a fair (20%) or poor (7%) rating.

“Not that long ago, people-and especially seniors-did not do much research before seeing their doctor and they blindly accepted whatever the doctor told them,” says Joy Stephenson-Laws, founder of Proactive Health Labs, a national 501c3 nonprofit health information company based in Burbank, California, and also founding and managing partner of Stephenson, Acquisto & Colman, a healthcare litigation law firm with four locations, including Burbank and Chicago.

Today, more seniors are empowering themselves with the information they need to better partner with their healthcare providers, according to Stephenson-Laws.

“By doing so, seniors may have a more positive outlook on healthcare since they are playing a more active role in decisions related to their health,” Stephenson-Laws says.

Factors impacting seniors’ views

One factor impacting how seniors view the healthcare they receive is where they live, she says.

“Those living in less rural areas may report more positive feelings since they may have easier access to healthcare services,” Stephenson-Laws says. “On the other hand, many seniors who live in more rural areas or in smaller communities, for example, may have unfortunately had to face a wave of hospital closures which usually creates a good amount of uncertainty and concern. They may be asking themselves, ‘Where do I go now for healthcare?’ or ‘Will I feel comfortable with a new doctor?’ This type of anxiety could very much impact how a senior sees the healthcare they are receiving or have access to.”

Related: 65 Is The New 45: Five Ways Seniors Can Reach Well-Being Goals

Other factors may include seniors’ increasing acceptance, preference, and approval of Medicare Advantage (MA) plans, or, Medicare Part C capitated health plans.

“These plans are becoming increasingly popular. Even though only a third of Medicare recipients currently are enrolled in them, enrollment has doubled over the past 10 years,” she says. “Seniors like these plans because they offer financial and coverage advantages over other programs. Many also like the convenience these plans offer. Reportedly, almost 60% of seniors who switch to MA believe they are getting better healthcare and health outcomes, as well as lower out-of-pocket costs, better prescription drug coverage, and in-network access to providers.”

Another aspect to consider, according to Stephenson-Laws, is that as seniors enjoy longer healthy life expectancies-versus just longer-life expectancies-they tend to have a more positive outlook in general. “If they attribute this better perceived health-which includes emotional health, physical health, mobility, and social interaction-to the care they are receiving, then this too may increase their positive view of the healthcare they receive,” she says.

What to consider

Two things are important for managed healthcare executives to consider when it comes to senior health and healthcare, according to Stephenson-Laws.

•  The senior population is going to continue to grow, necessitating a proportionate increase in available healthcare resources. “By some estimates, the number of seniors aged 65 years and over is expected to increase to more than 95 million by 2060, representing almost 25% of the total population.

• The preference and demand for managed care for seniors is only going to continue to increase. “Depending on which research you use, some experts are now predicting that over the next several years the number of seniors enrolled in MA programs will increase to almost 50% of Medicare recipients,” she says. “This number will most likely be higher as more states require managed care for government healthcare programs.

“Putting this all together, assuming that MA programs cap at 50% enrollment-which is not very realistic, but it provides a good yardstick-MCOs may have almost 50 million participants by 2060. I would doubt that many MCOs are prepared for such explosive growth in enrollment numbers.”

Being prepared for that growth is key because the financial and operational impact of this growth could be substantial if you consider the following:

• There will be an increasing demand for specialized healthcare workers and especially those skilled in gerontology ad related fields. “There currently are fewer than 10,000 practicing geriatricians in the U.S. and demand for this specialty is expected to grow to over 36,000 by 2030,” Stephenson-Laws says. “This demand could create upward salary pressure and impact ongoing care.”

• Government and private sector spend on senior healthcare will continue to increase disproportionately to other expenditures. In the U.S., for example, someone turns 60 years old every eight seconds. “This increase can rapidly outpace government and private sector ability to pay for required healthcare services even in a capitated, managed healthcare environment,” she says.

From a community and population health perspective, MCOs need to be prepared to play a greater ongoing role in helping seniors stay healthier in the first place. With people living longer, MCOs, and the healthcare community in general, can play an important role in ensuring that healthy life expectancy increases along with life expectancy, Stephenson-Laws says. “Doing so will also have a positive financial and operational impact on MCOs,” she says.

How to promote senior health

Things that managed care executives and their organizations can do when it comes to ensuring a healthy life expectancy includes:

• Educate patients and the community about good nutrition, exercise, and lifestyle changes (such as quitting smoking) and the role these play in getting and staying healthy. “They also can lead by example by removing junk food from cafeterias and gift shops and substitute healthy foods as well as launching, expanding, or implementing ongoing educational programs,” she says.

• Providers, and especially those associated with teaching and research institutions, can support or get involved with research into the causes of age-related diseases and especially the development of multi-morbidities. “There is much research on specific age-related conditions, all of which are making a major difference in peoples’ lives, but since most older people suffer from multiple diseases, this type of research would go far in helping close the healthy life expectancy and life expectancy gap. Being able to do so would create a win-win for everyone,” Stephenson-Laws says.

• Keep in mind that with seniors there is no such thing as a “one-size-fit all” approach. “It’s important to not lump them into one group or give in to the temptation of making generalizations,” she says. “What seniors need and want at different stages in their life cycle need to be factored in to your MA program. This could include exercise programs and gym memberships, opportunities for social interaction and, ‘care for caregivers.’”

• Develop programs to help seniors make sense of the options your organization is offering them. “Many seniors often spend more time shopping for their cable or cell phone service than they do for MA programs,” she says. “This may be due to the complexity of many plans that make them almost unfathomable to most seniors. By doing what you can to help seniors make the best decisions, everyone benefits.

“Last, but certainty not least, keep in mind that seniors may not be as technologically illiterate as you may think. So, be ready to communicate with them via email, provide online appointment booking and test results, and offer them educational materials in a variety of formats, including digital.”