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Will ‘Baby Boom Tsunami’ Swamp Healthcare, Other Services?

Deputy human services commissioner details challenges inherent in treating New Jersey's largest graying community.

State Deputy Human Services Commissioner Lowell Arye.
State Deputy Human Services Commissioner Lowell Arye.

Just as New Jersey’s hospitals once stretched to provide maternity-ward bassinets for the baby boom, healthcare providers will be striving to serve the post-World War II generation as it ages.

The population bulge born between 1946 and 1964 will increase demand for everything from new technologies for those with vision and hearing disabilities to the amount of adult education available for those embarking on second and third careers, Deputy Human Services Commissioner Lowell Arye said in a lecture titled “The Baby Boom Tsunami” at Mercer County Community College yesterday.

While Arye sketched out the increased challenges posed by a generation that is short on savings and in need of a broad range of services, he also noted that boomers are healthier than previous generations of aging Americans.

In addition, he said that the state is making changes to allow older residents to receive more home-based care, potentially reducing demand for nursing homes.

Both baby boomers and those planning to provide services for them must consider what it will mean to have the number of residents older than 85 increase substantially by 2030, he said.

The U.S. Census Bureau projects that the number of New Jersey residents older than 85 will grow from 179,000 in 2010 to nearly 300,000 by 2030.

“We have to figure out what’s the impact on society,” Arye said. “What we always have to remember is that boomers changed society in every stage of their lives.”

Arye noted that residents in their mid- to late 60s are healthier than similar cohorts were in the past.

For the next 10 years, the demand by active boomers in their 60s and early 70s may focus on education and training to build second and third careers in order to supplement Social Security and savings. Arye noted that Americans’ retirement savings haven’t kept pace with their projected needs.

While 7.2 percent of New Jersey seniors have incomes below the poverty line, 42.6 percent are below the economic index developed by the New Jersey Foundation for Aging, which is based on a broader set of basic living expenses. With the potential for increased cost-sharing for Medicare, many seniors may struggle with healthcare expenses, Arye said.

“I think that we need to continue to have the conversation and to have a true dialogue about what we are going to do for our baby-boom generation and beyond,” Arye said, adding that there are roadblocks to federal action.

“The nation right now is unfortunately very divided, it’s very divisive. Nobody’s truly willing to look across the table and talk to each other,” he said.

According to Arye, this generation will ultimately require more healthcare services, from relatively healthy boomers who will need knee and hip replacements to a projected increase in Alzheimer’s patients.

Arye pointed out a recent study by RAND Corp. and University of Michigan researchers that estimated that the annual cost to the country of dementia-related illnesses is currently between $159 billion and $215 billion and could double by 2040.

“We need to start to think about how we are going to work with those individuals,” Arye said.

A combination of medication, physical therapy, and at-home assistance can help people with Alzheimer’s stay at home longer than would have been possible in the past, he said. This is part of a broader demand for older residents to remain at home as long as possible.

The state has already taken a crucial step that will prepare it for providing home-based services by successfully applying for a federal global Medicaid waiver, said Arye, who previously worked as a policy adviser to Gov. Chris Christie.

The state will be paying managed care organizations for both nursing home and at-home and community-based services, but the payments are structured to provide incentives for residents to receive care at or close to home.

“They’re going to want to support people in the home community, so that they’re no longer at financial risk,” from being placed in nursing homes, Arye said of the managed-care organizations.

Arye noted a variety of job categories that will see an increase in demand from the aging population, including architects who can build and alter houses to make them accessible for residents with limited mobility and experts in “polypharmacy,” the use of multiple medications.

“There are opportunities for innovation across everything” affected by this generation, including assistance with technology for a generation that is more comfortable using computers than many of today’s seniors, Arye said.

There will also be an increased demand for palliative and hospice care, Arye said.

Doctors and nurses “don’t want to think about somebody dying, and how to work with families,” Arye said. “That is a huge piece that the medical community as a whole has not as much focused on as we really need to.”

The issues that Arye raised have implications for future state healthcare policy, according to Joel Cantor, director of the Rutgers Center for State Health Policy. The demand for services for seniors will put pressure on the state budget.

“There’s more we can do for people who have hearing loss or vision loss or chronic illnesses, but these things cost money,” Cantor said. He added that while significant, the aging of the state’s population accounts fore less than 20 percent of the factors that have been driving up the cost of healthcare. Increases in how much providers charge for services and an overall increased demand for services are larger factors.

Cantor also said the state could save money through the Medicaid waiver, while enabling residents to stay at home.

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