My Healthcare Take-Aways from the 2024 DNC

Last week's Democratic National Convention in Chicago was more than just a memorable gathering of long-time friends and a deep bench of elected officials on display. It was a turning point for the future of the American healthcare landscape.

The convention underscored the party's unwavering commitment to expanding access to healthcare and making it more affordable for all. It was a clear signal that the Democratic Party is aligning its policy agenda with the profound shifts happening in the "Care" economy, a sector that's growing in size and significance.

Healthcare was a central theme, with the party rallying behind key policy pillars such as protecting reproductive rights, improving the Affordable Care Act, reducing prescription drug costs, and forgiving medical debt. What stood out was the recognition of the hidden costs associated with the "Care" economy—especially the twin challenges of affordable childcare and eldercare, which weigh heavily on American households.

Recent research by Boston Consulting Group in May 2022 estimated that the care economy—encompassing both paid and unpaid caregiving—could be as large as $6 trillion, nearly a quarter of the U.S. GDP. This massive sector is predominantly supported by women, many of whom juggle responsibilities in childcare and informal caregiving for adults. As the U.S. population ages, the demand for home health aides and personal care workers, many of whom are immigrants, will only increase.

Compounding this shift is a transformation in where and how care is delivered. The American Hospital Association's 2024 annual survey reveals a steady decline in staffed hospital bed capacity, and nursing home capacity dropped by a staggering 25% between 2011 and 2019. This signals a paradigm shift: care is moving away from traditional, institutional settings and increasingly into the home.

With these demographic changes and economic forces at play, the implications for technology innovators and policymakers are profound. The Center for Medicare & Medicaid Services (CMS) is already integrating the care economy into programs like Medicare Advantage and Medicaid 1115 waivers, emphasizing the importance of long-term services and supports (LTSS), home and community-based services (HCBS), and dual-eligible special needs plans (D-SNP).

As healthcare continues its shift from a hospital-centric model to a community-based, coordinated care approach, several areas will become increasingly vital: case management, community health worker (CHW) assistance, screening and referral for social determinants of health (SDOH), and support for insurance eligibility and navigation. Additionally, new considerations such as the built environment, caregiver engagement, navigation for multigenerational households, and culturally congruent practices—particularly for Latino households—will need to be addressed to meet the evolving needs of this aging and diverse population.

In this evolving landscape, the convergence of demographics, labor economics, and market forces is not just reshaping the healthcare delivery model; it's redefining what it means to provide care in America. The challenge and opportunity for policymakers and innovators alike lie in adapting to these changes, ensuring that the care economy is not only sustainable but also equitable and accessible for all.

Hickman Strategies is excited to be working in this dynamic environment with our clients and partners to better serve the care needs of families and communities.