HEALTH CARE INDUSTRY

Health Care Industry



Introduction

The U.S. health care industry is standing on the precipice of an ever widening and deepening chasm. The breadth and depth of the health care chasm is affected by economics fueled by the unsustainable costs of providing services to an aging population and not having the means to pay for the costs. Reimbursement changes are driving physician-hospital integration primarily through physician employment models. Population growth primarily due to the baby-boomer population who start turning 65 years of age on January 2011 will increase demand for cardiac and vascular services. Timely and convenient access to services will be problematic as the number of physicians required may be stretched to capacity coupled with the likelihood that many cardiologists take early retirement given reimbursement changes. Augmenting the reimbursement challenges is the ever shrinking number of workers per Medicare beneficiary. Current legislation does little to address these challenges and may actually exacerbate them (www.cms.gov, 2007).

Population Growth

Demand for cardiovascular services will increase as the incidence and prevalence of cardiovascular disease “controllable” or behavior-driving factors such as higher body mass indexes, diabetes, and high blood pressure continue to affect more of the population. In addition, the composition and growth of the U.S. population will become more of a factor as the first of the baby boomers begin turning 65 years of age in 2011 and enter the prime demand age category for cardiovascular services. Based on the latest available cardiovascular inpatient utilization data (Lloyd-Jones et al., 2006), persons in the 65 years of age and older age category use cardiovascular services at a rate more than twice that of persons in the younger two age categories (15-44 years and 45-64) combined. The utilization rate for all cardiovascular inpatient procedures for persons 15 to 64 years of age is 41.1 per 1,000 persons compared with 98.3 per 1,000 persons for the age category of 65 years of age and older. As shown in Figure 1, the age category of persons 65 years of age and older will grow at a rate that is more than three times that of the U.S. population growth rate for the next three 5-year periods of 2011-2015, 2016-2020, and 2021-2025 and will be more than twice as high for the last 5-year period of 2026-2030. Therefore, the demand for all cardiovascular procedures will increase as a result of the increase in the number of persons 65 years of age and older (Mattlin, 20100).

As a result of the aging of the population and the growth rates associated with the various age categories, 2011 becomes the “tipping point” for the composition of the U.S. population for each of the significant cardiovascular-related age categories. Starting on January 1, 2011, the 78 million baby boomers will begin turning 65 years of age at a rate of one person every 10 seconds (Mattlin, 2010). As shown in Figure 2, the 15 to 44 and 45 to 64 years of age categories will begin or continue to experience downward trends in their ...