Over the next several decades, the age of the U.S. population will shift dramatically, with people 65 years and older reaching nearly 84 million — almost double the population since 2012. From a health care perspective, this rapid growth, combined with an increase in health needs for a population that is living longer, will create a tremendous burden on our health care system.

The rising cost of U.S. health care, especially in the last phase of life, desperately needs to be addressed. Also, how we are going to coordinate and deliver care for seniors in their communities and in their homes — the places where people prefer to receive care — must also be determined.

How to care for an aging U.S. population

At the foundation, we see a number of opportunities to begin addressing how to care for people in the community and at home: building new models that integrate the currently fragmented array of primary, specialty and end-of-life care services; broadening the scope of palliative, or comfort, care programs beyond hospitals and into the home; expanding the use of telehealth; coordinating with social services agencies; and providing much needed support to the more than 42 million unpaid family caregivers. But that isn’t all, and any efforts will require the entire health care system, as well as government, to work together.

The July issue of Health Affairs, the leading peer-reviewed health policy journal, is dedicated to this topic. The special issue features a number of health care experts from across the country who are studying and identifying ways to make improvements for our aging society. Two areas that interest us in particular are addressed by foundation grantees and lead authors Dr. Joan Teno, professor at the University of Washington in the division of gerontology and geriatric medicine, and Dr. Diane Meier, director of the Center to Advance Palliative Care.  

Dr. Teno, along with her colleagues, writes about measuring care that is delivered in the community. Currently, there is no standard approach to assessing health care programs that deliver care to seriously ill patients in the community. Therefore, we have no way of knowing what is working well or is not in these different offerings.

Dr. Meier, along with her colleague Dr. Sean Morrison, and Dr. Anthony Back, Dr. Susan Block, and Amy Berman of the Hartford Foundation and our Chief Program Officer of Patient Care, Janet Corrigan, write about a comprehensive strategy for palliative care in the U.S. entitled "A National Strategy for Palliative Care."

As we continue to explore how we can contribute to improving the experience and outcomes for patient care, particularly high-need patients, learn with us. Our program director, Diane Schweitzer recently penned a perspective on how serious illness care has shifted over the past century, and another perspective from program officer Beth Berselli discusses building a consumer protection system for care delivered in the community. We hope you will read both.






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