Under the Accountable Care Act (ACA), Medicare instituted the well-intended concept of paying providers to conduct a risk assessment of their patients including a proactive anticipatory plan of care needs for the year under what is called the Annual Wellness Visit (AWV). Despite such incentives being in place for over a decade, we continue to see only a minority of Annual Wellness Visits completed with some reporting less than 20% of the population that could have benefited from such assessments. Risk assessment and anticipatory planning can have huge benefits in reducing wasted health care costs and avoidable health-related issues by identifying and addressing conditions or risks earlier.

The U.S. healthcare delivery system has always remained largely a direct“person to person” interaction but such thinking has been changing as the industry is adopting technologies that others have already pivoted towards in providing greater access, speed and efficiency. The banking industry is a great example familiar to those who can recall the days of bank tellers and account managers whereby customers accessed physical locations for most of their financial transactions. As technologies like ATMs then mobile emerged, banks quickly realized that large physical locations were no longer needed and the speed of transactions untethered from brick and mortar could now allow for banking services to occur at the speed of electronic transmissions. As such, financial institutions today are processing over 726 Billion transactions a year.

With the increasing movement toward value-based care and consumer viewpoint on personalized health, healthcare delivery organizations are beginning to recognize the importance of a fully integrated and more wellness-based holistic approach in seniors. This“whole person” approach examines the biological, psychological, and social determinants of health and well-being. It recognizes that all 3 domains play vital roles in the quality of life and health status. The ability to perform an extensive intake assessment for each of these domains to generate a personalized health-guided profile and evidence-based clinical approach to maintaining health, vitality is critical to preventing complications associated with chronic medical and psychological conditions as well as unmasking and addressing social determinants of health.

As a primary care physician with an older surviving mother, I found myself in a territory similar to millions of families across America. Concerns around an aging mother and her changing health care status, as well as more immediate needs for her to remain independent but safe at home, became a regular conversation with my siblings. While the children of our aging mother were spread across the country, much of the physical burden rested on one child who happens to live one city away. Daily visits and help with activities of daily living engulfed my brother and his wife's time and attention.

As the U.S population continues to age, we are seeing over 10,000 Medicare enrollees entering into the system each and every day. As a result of the aging generation, the US Census Bureau, predicts older adults are expected to outnumber their children for the first time in U.S. History by the year 2034. As such, a recent study projected a shortage of filled positions for healthcare-related jobs caring for older adults. How will the U.S. health care system be able to manage this surge of growing need? The unfortunate recent impact of the COVID crisis unmasked the vulnerabilities of our health care delivery and support systems for older adults in the U.S. and abroad. With the overwhelming aging population and lack of support and critical infrastructure, new approaches to caring for older patients need to be considered.