If 2024 is the year you turn 65, you’re not alone. Research suggests that 2024 marks the beginning of the “Peak 65 Zone,” with more Americans turning 65 this year than at any other time in history.
As people age, they typically require more healthcare services due to an increase in age-related health conditions, disabilities, and chronic diseases. Recent research has found that chronic conditions are becoming more common in patients nationwide, causing sharp increases in national healthcare spending. The economic burden of chronic conditions is already crippling our healthcare system, with the number of chronic conditions under treatment being a key driver of spending growth. Now is the time to closely examine how chronic conditions are being prevented and treated in America, so we can improve outcomes both for those currently living with these conditions and for future generations of aging Americans.
When it comes to chronic conditions, health systems have played a pivotal role in both managing and trying to prevent them. However, these organizations face complex financial landscapes, including dwindling reimbursement rates, increasing operational costs, and staffing shortages, all of which affect their effectiveness.
Despite these challenges, nonprofit health systems are proactively investing in community-based programs aimed at prevention and whole-person care, leveraging their financial flexibility to promote long-term health outcomes. These groups are paving the way for innovative solutions that prioritize both the health and financial well-being of our communities.
Take, for example, a food security program implemented by Sutter Health’s longtime community partner, Yolo Food Bank to promote greater access to fresh, healthy foods. After research found one-third of all Yolo County households have food insecurity and that more than half of those families have an agricultural worker in the home, the hospital system invested $200,000 in the Yolo Food Bank’s “Cultivo” program, which brings more equitable access to food directly to agricultural workers via monthly pop-up food distributions in their neighborhoods and their places of employment, such as fields, farms, packing plants and canneries. Because access to fresh, healthy food plays a role in preventing and managing chronic diseases, such as diabetes and coronary artery disease, and contributes to overall well-being and mental health, dollars invested in this way can pay significant returns over time.
Health systems know that reducing the impact of social drivers in their patients’ lives leads to better health self-maintenance and improved health outcomes. UnityPoint Health has embedded a standardized screening of social drivers of health into their electronic health record to help their care teams at all points of the care continuum see a more comprehensive picture of a patient. This allows their care teams to proactively implement care management and treatment strategies that address the whole health of the patient to decrease the risk of negative health outcomes. Patients are also able to view and update their assessment within MyChart as their situation changes, giving their care team the most current information. UnityPoint Health is also investing in a community health worker program that puts more community health workers in both its clinics and hospital spaces to further assess the social factors that may impact health outcomes and help ensure patients are connected with appropriate low or no-cost resources within their zip code.
These initiatives represent only a microcosm of what is needed to combat chronic conditions at scale. If we are looking ahead to how we can prevent another wave of crippling high-cost care, we need to shift the fundamental way we think about preventing and managing chronic diseases. An aging population demands more efficient and effective prevention and chronic care management, and health systems can't tackle these challenges alone. Policymakers need to advocate for integrated care models and prioritize reforms that emphasize coordinated, chronic care management, as well as invest in social services.
For example, a recent whitepaper from the Novant Health Center for Public Policy Solutions sheds light on a regulatory barrier clinicians face when treating patients with chronic conditions: depending on the patient's insurance plan, their physician may be unable to address chronic conditions during their annual wellness exam. Clinicians need to be able to have conversations about chronic conditions before they get to the stage of management. Federal and state lawmakers should collaborate to ensure all insurers cover chronic condition management as part of patients' annual visits at no cost.
As we enter the “Peak 65 Zone” with a generation burdened by chronic conditions, we find ourselves at a critical juncture. If we do nothing, our already overwhelmed healthcare system will only be further strained. To avoid this, we must pursue two parallel paths: one that prioritizes prevention and another that invests in new systems of care, shifting from episodic treatment to continuous management of chronic conditions. Taking a long-term view of prevention and care is essential if we are to avoid repeating history and improve the outlook for both current and future aging generations.