Is Your Health System Ready for the Boomer Surge?

The numbers are shocking, though we’ve heard them before: in 2030, the population of people in the U.S. eligible for Medicare will have doubled?to about 70 million, from 35 million in 2000.

That is a record-setting number. By the end of this decade, Baby Boomers born between 1946 and 1964 will all be of retirement age, and there’s no question their healthcare expenses will rise dramatically.

So will their needs from providers and health systems like University Hospitals.

Besides just the raw numbers of future patients, illnesses and conditions that include cancer, cardiovascular disease, diabetes, prostate enlargement, cognitive impairment, falls and osteoporotic fractures are exponentially more common with age.?

There are always factors we can’t anticipate about the future, but we know the demand from patients will rise. We already are, and have been, preparing for this influx in many ways – especially in certain institutes and service lines that include UH Harrington Heart & Vascular Institute, UH Seidman Cancer Center, UH Urology Institute and our Division of Geriatrics.

In most areas, we continue to aggressively recruit more providers. And throughout UH we make it easier for patients to be seen by offering virtual appointments, or appointments closer to their homes.?In some places, we have Saturday or evening clinics, and we will continue to respond to patients’ need for access in novel ways.

Heart attacks are the No. 1 cause of death for men and women in this country. UH Harrington HVI, led by Mehdi Shishehbor, DO, MPH, PhD, President of our University Hospitals Harrington Heart & Vascular Institute and the Angela and James Hambrick Chair in Innovation, already addresses this multi-dimensionally.?

Simplifying access to clinicians so that patients can be seen in a timely manner is one way. Another is that treatment is radically different now for many procedures: open-heart surgery for aortic valve stenosis is just one that can now be done as an outpatient, in a minimally invasive manner, when it used to require a stay of several days. The risk of complications, morbidity and mortality drops way down but importantly, the recovery is so much faster.?

Nothing beats preventing cardiovascular disease and the need for surgery or treatment. The CINEMA program at UH Harrington HVI, for example, addresses diabetes, which often leads to cardiovascular disease. This educational program is designed to help those with the illness to aggressively address their high cholesterol numbers, hypertension and diabetes, not only on their own but through a network of UH providers.

Keeping patients healthy at home can be more powerful than any treatment – and minimizes the number of patients who need to be hospitalized or treated for advanced disease.

Cancer is largely a disease of aging,?so we can expect an ever-growing number of patients for our UH Seidman Cancer Center. That means preparing by having the optimal number of physicians and advanced practice providers (APPs) at UH Seidman, which is an ongoing effort.?

Better cancer outcomes are the main objective, and catching cancer early is key. That is done through screenings, such as for lung cancer, colorectal cancer, breast cancer and prostate cancer, and by educating patients on early cancer symptoms, such as unintentional weight loss.

More people than ever are cured or in remission from cancer for a long time, yet still have ongoing health needs that relate to both cancer and treatment, says Theodoros “Ted” Teknos, MD, President and Scientific Director, UH Seidman Cancer Center and the Jane and Lee Seidman Chair in Cancer Innovation. One study underway examines the benefits of exercise in helping older adults complete cancer treatments.

UH Seidman is known for innovations, and a new one is screening populations at a higher risk of certain cancers (such as firefighters and first responders) through cell-free DNA blood tests. These are sometimes referred to as “liquid biopsies,” and they can check for 50-plus cancers at one time.?

Also, through AI and our unified medical record system with EPIC, there will be more health alerts, data and patterns that will point toward a patient having cancer, leading to earlier treatment.

At UH Seidman and throughout UH, our ongoing innovations save lives, bring better outcomes, and at best, prevent disease. They are vital in keeping future patients healthier, and at home.?

While the UH Urology Institute takes care of men and women of all ages – including pediatric patients – there will certainly be more patients with age-related conditions, including urinary incontinence, enlarged prostates for men, issues related to sexual health for men and women, female pelvic issues of incontinence or prolapse, and for men and woman, kidney and bladder stones.

Enlarged prostates can now be treated quickly and efficiently in many men through a new method known as HoLEP (holmium laser enucleation of the prostate). Only a small percentage of surgeons can perform this, and UH has two of them. Men who are treated with HoLEP are usually between 55 and 90 years old, and this is another procedure that, unlike in the past, can now be done on an outpatient basis.

The Urology Institute has also expanded, with three times the number of providers it had six years ago, and is prepared for future growth, says Lee Ponsky, MD, Chair, UH Urology Institute, Executive Director of the UH Cutler Center for Men; Leo and Charlotte Goldberg Chair in Advanced Surgical Therapies; and Master Clinician in Urologic Oncology.?

This provides greater access throughout the UH service area, with physicians and nurse practitioners located at many practices in our 16 counties, including locations at the UH Otis Moss, Jr. Health Center in the Fairfax neighborhood in Cleveland. The expansion of the UH Cutler Center for men, and programs designed for minority men to address healthcare disparities, are another way of providing access and encouragement for men who have typically avoided physician visits. It also is aimed at getting men screened for medical conditions before they begin to advance.

Our Division of Geriatric Medicine, as you might expect, is also in expansion mode, under the leadership of Amanda Lathia, MD, its Division Chief. That means recruiting physicians and creating collaboration between her division and other service lines. Among her initiatives and goals are the creation of a “falls clinic” and a “post-fracture osteoporosis clinic,” which will help older men and women prevent what is a leading cause of death.?

Others are increasing geriatric consultations for older patients, who often deal with the results of poly-pharmacy – meaning symptoms that might mimic illness but are actually a result of too many prescriptions, some which may no longer be needed; others are troublesome interactions from medicines that should not be combined, and having the understanding that older patients’ bodies do not process medicine as they once did.

On many fronts, we are preparing for the influx of older patients, which is already underway. Undoubtedly, there will soon be more ways in which we innovate, improve efficiencies and address the specific needs of this population that we already treat.?

And always, this will include delivering the kindness and compassion that is particularly called for when caring for these many, and often quite vulnerable, patients.