future trends in health care and the positive outlook for nursing carol a. irvine president and ceo...
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Future Trends in Health Care and thePositive Outlook for Nursing
Carol A. Irvine President and CEO
April 12, 2015
www.abramsoncenter.org
Abramson Home Care
Mildred Shor Inn (46 Market Rate PC &
2 IL Units)
Nurse Practitioner Primary Care / House
Calls
Remote Health Monitoring / Telemedicine
Birnhak Transitional Care (54 Beds)
Abramson Hospice
AbramsonResidence
(270 LTC Nursing Home Beds)
MedicalAdult DayServices
Outpatient Service Renal Dialysis
Abramson Care Advisor (Info & Referral/Geriatric Care
Management)
Bundled Services
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Why engage in a partnership with Penn State CON and the Hartford Center?
Supports our vision as an organization to …..
Rooted in Jewish traditions and valuesProvision of exceptional care Lead through innovation Pioneering research
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Why engage in a partnership with Penn State CON and the Hartford Center?
For over 50 years research has been in our DNA. We believe the care environment should serve as a “learning laboratory” for how to deliver better Person-Centered Care.
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Why engage in a partnership with Penn State CON and the Hartford Center?
Reality of the Journey of Evidence-Based research into practice
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Expands the benefits of embedded research in a long term care community….
Bringing Meaning and Hope to the Lives of those we serve Staff Pride and CapabilitiesSupports Philanthropic Efforts Supports Better Quality of Care and Quality of Life Person Centered OutcomesIt’s a Market Differentiator that Raises the Level of Just About Everything Increased Potential ReferralsAttracts Payer Relationships and Partnerships
Why engage in a partnership with Penn State CON and the Hartford Center?
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Access to “state of the science” information through access to educational opportunities for staff through the Hartford Center Opportunity to participate in educating the next generation of care providers…..
Ellie Brnich, HPA Administrator in Training, PSU Hoffman Scholar
Emily Munn, HPA Administrator in Training
Lauren Bangerter, MA, HDFS Pre-Doctoral Hoffman Scholar
Allison Heid, PhD HDFS Post Doctoral Fellow, PSU Hoffman Scholar
Andrea Yevchak, PhD, Nursing
Why engage in a partnership with Penn State CON and the Hartford Center?
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Well Researched Megatrends, Cross-Cutting Business Applications
Demographics/ Relevance
Technology
WorkforceFunding/ Financing
Extensive Readings
Interviews, Site Visits, Webinars, More Readings
White Papers/ Predictions
Cross-cutting Business Applications (5 Years), Business PlansAnnual Review/Course Correction2015-2030
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Global Predictions from Research, Next 10 Years
No cure for Alzheimer’s DiseaseHome-based services and retail healthSignificantly more elders with chronic care needsGenerational wealth transfer but fewer assets for
elders on average Technology-dependent lives, personalized
medicinePartnerships with strange bedfellows, competition
from multiple other sectorsThe end of volume-based third-party payment
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Demographics/Relevance Predictions 2015-2020
Volume in market who need/can afford home care• 19% increase in old-old• Significant increase in chronic
diseases• Greater percentage of elders
at homeFewer move to senior living: older, more medically complex, fewer assetsComorbidities require more home health care (house calls), not just supportive services
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Demographics/Relevance Predictions 2021-2025
Greater market for home care (health and supportive)• Government payment• Disease-specific advocacy groups• Increase in old-old (33% between
2020 and 2030)Services tailored to greater diversity (LGBT, non-Caucasians)Lower LTC occupancy means at least 40% fewer nursing home beds needed for LTC in Pennsylvania
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• Home, Wearable, Mobile and Telemedicine Technologies• Remote patient monitoring• Medication optimization• Assistive technology• Remote training and supervision• Technology supported disease
management• Telemedicine (diagnostics and
interventions)• Cognitive fitness and assessment• Social networking
• Genomics, Personalized Medicine and Biomedical Technology Advances
• Health Information Technologies, Electronic Health Records (EHRs), Data Analytics and Big Data
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Technology Predictions 2015-2020
• Wearable's become medical grade, tele-monitoring by large monitoring centers, telemedicine common and reimbursed
• Big data, predictive analytics begin to govern care resources for targeted populations; data sharing among providers cumbersome but required for payment
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Technology Predictions 2015-2020, cont.
• Personal genomic information available, but few providers can use
• High tech-high touch strongly desired
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Technology Predictions2021-2025
• Implanted sensors alert caregiver of health problems
• Universal smart chips with all personal health information
• Personalized medicine via genomics; no cure for Alzheimer’s but targeted drug therapy to defer decline
• Gamification = consumer engagement results in deferral of onset of chronic diseases for pre-old and young-old; redesigns rehabilitation
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Funding/Financing Predictions: Medicare and Medicaid 2015-2020
Medicare/managed care payments tied to quality and efficiency outcomesMedicare managed care at 35%Post-acute bundled payments by 2020Hospital mergers and closures• Declining Medicare
revenues per admissionMedicaid mostly managed care
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Funding/Financing Predictions: Medicare and Medicaid 2021-2025
Fee-for-volume payment disappears
Payment tied to population health outcomes
Strong growth in home-based targeted complex care management based on predictive analytics
Highly dependent technology Home health/homecare model
Medicaid managed carePreferred networks for post-
acute and long-term care
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Work Force: Predictions for Shortages
2015-2020• Physician, therapist, pharmacist
shortages (offset some by NPs, PAs), nursing shortages severe in certain regions; major issue will be direct care workers
• Special training in chronic disease management/dementia care needed
2021-2025• Quantified significant shortages in
licensed personnel and direct care workers; salary pressures
• New roles for pharmacists (CVS-Minute Clinics)
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Workforce: Predictions for Technology 2015-2020
Technology training Compliance activitiesNo reduction in workforce 2021-2015Integrated Electronic Health Record = team-based care modelsLess skilled workers duties formerly only by professionalsNew job categories based on technologiesAssistive devices allow workers to remain in workforce longer
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The Role of the Nurse in
2025
More ethnically, culturally,
generationally diverse
Chronic disease and dementia mgmt. Educator/ focus on
prevention
Educated (min. BSN)
Technologically savvy
Care mgmt. via multi-disciplinary
teams
Advanced role in primary care
Evidence-based care/outcomes
Flexible and adaptable to rapid
change
Works in nontraditional/ non-institutional roles
Leader in Person Centered Care focusing
on the whole person
Owner of Holistic Views of Patient
Health Care Leader
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From Research to Predictions to Business Applications to Plans
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