The Care Continuum Is Bracing for Widespread Change Due to Demographics and Financial Pressure

April 1, 2021
April 1, 2021

As America ages at an increased pace, the impact will be felt across the care continuum. Senior living will be especially affected as it works to adopt a medical model that also blends aspects of the hospitality and healthcare industries. Concurrently, older adults’ expectations about their accommodations continue to rise, even as their medical needs increase. Residential care environments will soon need to be able to track medication management electronically. When you take into account that the typical person over age 65 averages six maintenance medications daily, it’s not hard to predict that more care will also be required. With 10,000 people reaching age 65 every day, it is projected that we will need more than 3 million additional senior housing units by 2040. Where separate levels of residential and supportive care have been the rule, the care continuum will blur into one where all services can be provided, culminating in an environment that is patient-centric rather than care setting-specific (, 2015). At the same time, one area of the continuum is on the threshold of serious turmoil. For the home health sector, the Payment-Driven Groupings Model (PDGM) took effect January 1, 2020. This massive CMS reimbursement overhaul is another patient- and reimbursement-focused wave of change, where therapy will now be tied to patient characteristics, rather than being reliant on a predetermined number of visits. Predictions about the impact include cash flow issues for some home health care providers, more than 30% of whom are expected to close. Consolidations among agencies may take place rapidly, and some experts fear the development of home health care deserts, which CMS plans to monitor closely. As part of this transformation, telehealth is expected to begin to play a sizeable role, for remote monitoring of conditions and data collection linked to reducing readmissions. Nearly 30% of home health care agencies have said they plan to launch telehealth services by 2021. A final worry for home health and boon for compliance professionals is the official CMS commitment to hunt more aggressively for fraud (Holly, 2020).


Holly, R., “The Top Home Health Trends of 2020,” Home Health Care News, January 6, 2020, Retrieved at the-top-home-health-trends-of-2020%EF%BB%BF/Hol., “2020 Vision: The Future of Senior Living,” 2016, Retrieved at

This blog post is an excerpt from the longer HealthStream article, Trends That Will Shape the Next Decade in Healthcare. Focused on the people providing healthcare, HealthStream is committed to helping customers address and solve big problems in our industry. From hospitals to long-term care and across the care continuum, there are challenges stemming from demographic changes, governmental mandates, and the need for higher care quality. Download the webinar, Ten Healthcare Trends for 2020, where Robin Rose, Vice President, Healthcare Resources Group, HealthStream discusses this information in detail. HealthStream is dedicated to improving patient outcomes through the development of healthcare organizations' greatest asset: their people. Learn more about our healthcare workforce development solutions.