by Scott Zimmerman
Every eight seconds, another baby boomer qualifies for Medicare. By the time you finish reading this, 38 more people will become eligible for the program. One significant challenge our nation is facing is that Medicare, a program Americans depend on, is in dire financial straits.
As the population ages, Medicare will expand healthcare coverage from 47 million people today to 80 million in 2030, and its costs are projected to balloon to $929 billion by 2020, an 80 percent increase over 10 years.
With these figures in mind, the Centers for Medicare and Medicaid Services predict the program will run out of money in 2017.
In order for the Medicare program to be economically sustainable, the healthcare industry must shift its focus away from primarily treating illness to a more holistic approach aimed at keeping people healthy.
According to findings from our new study, “Healthcare Change: The Time is Now,” more than half (56 percent) of American baby boomers do not feel good about their overall personal health, and one in four (26 percent) say they are struggling to be healthy. This feedback is a wakeup call highlighting the importance of preventive care and of the need to change the culture of reimbursement so that healthcare providers are motivated to focus on wellness.
We’re already seeing the industry begin to move in this direction. As part of the Patient Protection and Affordable Care Act that was signed into law in 2010, the new Medicare wellness benefits task doctors with creating personalized prevention plans tailored to each patient’s daily routine, mental health and family life. Based on identified areas of risk, physicians are expected to work with their patients to schedule the appropriate preventive benefits such as flu vaccines, smoking-cessation counseling and regular mammograms. Or preventive screenings for diabetes, colon cancer and prostate cancer. Or free screenings for blood pressure, body mass index and depression issues.
Unfortunately, two in three (66 percent) healthcare practices are ill prepared to create these personalized prevention plans, according to the study. The truth is, physicians’ historical care model has been to treat people who are sick. The incentives have not rewarded an intense focus on promoting overall health by improving their patients’ daily routines and concentrating on prevention.
The study also revealed the majority of Americans aren’t following through on their treatment plans. Only five percent of health care professionals give those in their care ‘A’ grades for strict adherence to their directions about becoming healthier, which jeopardizes the entire premise of outcome-based care, according to the study.
As medical practices adapt to the new healthcare requirements, they will be increasingly rewarded for outcomes that are best achieved by proactively managing care through preventive treatment plans and — more importantly — helping patients follow through on those plans.
Yet, although doctors are now being reimbursed by Medicare for talking with patients on an ongoing basis about healthy behaviors, 71 percent of healthcare practices surveyed report being unprepared to engage patients throughout the year in an effort to help them adhere to personalized prevention plans.
The reality is that patients know they have to take responsibility for their own health, but they need support and collaboration from their healthcare providers that goes beyond a visit, some advice, and a prescription.
The time required for this level of personalized engagement by physicians, nurse practitioners, or other staff — for thousands of patients in a practice — is perceived to be unrealistic. However, this degree of personalized care is possible when healthcare practices leverage multi-touch, multi-media notifications technology to automate follow-ups with patients that encourage them to schedule tests and doctor appointments, provide just-in-time medication reminders, and support them in making positive behavior changes to create a healthier lifestyle./p>
Keeping people healthy through preventive care can reduce healthcare costs for our nation. And, today, care providers have an opportunity to help patients do a better job of living up to their good intentions by encouraging the right behaviors, soliciting questions, and even reminding patients to exercise, eat right and take medication between appointments.
But, with physicians already stretched for time, it’s essential they re-think the typical appointment, scheduling process, and patient engagement strategy; while leveraging technology to innovate and automate wherever possible. There are simply too many patients.
Originally published on The Herald News, July 4, 2012