Lisa Eramo

Baby Boomers and Health Care: How Value-Based Care Can Help

Baby boomers and health care are two subjects that should be on every employer’s radar. There are roughly 75 million Americans born between 1946 and 1964 who will ultimately become eligible for Medicare by 2030. By that time, 1 in 5 U.S. residents will be of retirement age — that’s a whole lot of people suddenly relying on Medicare all at once, especially during a time when the number of people paying into Medicare continues to decrease.

The Centers for Medicare and Medicaid Services (CMS) estimates that by 2027, federal, state and local governments will finance nearly half of health care spending as baby boomers age into Medicare. Particularly since more boomers have chosen to work past the age of 65, employers should choose health plans that help employees of this generation become and stay healthy.

Baby Boomers and Health Care: Prevention

One way employers can start supporting healthy choices is by offering health and wellness programs meant to target this population. For example, they might provide nutritional counseling that addresses concerns for osteoporosis and heart disease or introduce yoga classes to improve employees’ flexibility and strength.

Employers should also encourage baby boomers to choose a primary care physician, take advantage of the Initial Preventive Physical Exam (otherwise known as the Welcome to Medicare Exam) and have annual checkups. This preventive care helps older employees identify and address chronic conditions common to this generation, such as obesity, hypertension, hypercholesterolemia and diabetes.

Easing the Strain on Health Care Professionals

One challenge on the road to improved health care for baby boomers, however, is the anticipated shortage of providers. As older health care professionals retire, they’ll be replaced by Gen Xers and millennials, many of whom want a healthy work-life balance and may not be as willing to compromise their own health to accommodate more patients. To combat this challenge, employers can offer on-site health screenings and choose health care insurance options that include telehealth and other health care innovations like remote monitoring.

Tackling Other Health Care Challenges

As they age, baby boomers also face other health-care-related challenges. For example, many people of this generation have largely underestimated their total health expenses. The average 66-year-old couple who retired in 2018 needed 48% of their lifetime Social Security benefits to address total lifetime health care expenses. Yet 63% of baby boomers leave health care expenses out of their savings goals because they’re unsure of the costs.

If patients can’t afford health care services, they may simply forgo care, leading to costly hospitalizations later down the road. Employers should aim to offer commercial plan options that provide maximum coverage when Medicare is a secondary payer, as well as encourage any baby boomers on staff to use health savings accounts (HSAs) when possible. It could also make sense to provide access to financial advisers who can help baby boomers create financial plans that account for health care expenses.

Improving Health Care With Value-Based Care

Other value-based, industry-related changes may also help improve baby boomer health. For instance, the CMS has developed various new payment models that promote care coordination between internists and specialists, focus on prevention, improve care quality and support baby boomers in achieving their health goals. Additionally, the Merit-Based Incentive Payment System rewards physicians for providing high-quality, low-cost care to Medicare beneficiaries for services such as advance care planning, fall risk assessments and screening for hepatitis C and osteoporosis. Medicare also pays for providers to assist baby boomers with managing their chronic conditions and transitioning from the hospital back to their home. The sooner Medicare expands these and other health care improvements, the faster baby boomers will receive much-needed services to manage their conditions.

Employers play an important role in supporting baby boomer health. Employer-led initiatives, combined with payment policy changes, will provide the much-needed support necessary to keep this generation healthy and thriving.

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