The Senior Care Value Equation

How redefining success metrics is transforming elder care delivery and improving outcomes

BY KAREN MARIE JOSWICK, MHA

DELAWARE FACES a significant demographic shift, with its aging population projected to grow dramatically in the coming years. By 2025, Delaware’s population has reached over one million residents, with over 20% of the population aged 65 or older. This demographic reality presents challenges and opportunities for health care providers, businesses, and policymakers across the state.

Traditional fee-for-service health care models are increasingly ill-suited to serve this growing senior population. Value-based care (VBC) models offer a promising alternative by focusing on quality outcomes rather than service volume. As the Commonwealth Fund defines, value-based care encompasses “effectiveness, efficiency, equity, and patient-centeredness”—prioritizing evidence-based approaches that don’t waste resources, ensure equitable access, and respect patient preferences.

Why Delaware Needs Value-Based Geriatric Care

Delaware stands at a critical demographic crossroads that threatens the stability of its health care ecosystem. Population projections reveal a rapidly expanding senior demographic that will place unprecedented demands on a strained system. With seniors now constituting nearly one-fifth of Delaware’s population—and projected to grow substantially through 2040, particularly in Sussex County—the state faces an urgent capacity challenge.

This demographic shift creates a “perfect storm” for Delaware’s health care infrastructure. The expanding cohort of older residents with complex medical needs coincides with a contracting health care workforce pipeline. Research from the Association of American Medical Colleges paints a concerning picture: more than 40% of U.S. physicians will reach retirement age within the next decade, while the demand for specialized geriatric care continues to accelerate. Value-based care models that emphasize prevention, coordination, and targeted interventions represent Delaware’s best strategy for maximizing limited clinical resources while improving outcomes for seniors.

Redefining What Success Looks Like

Value-based geriatric care requires fundamentally different success metrics than traditional care models. As health care undergoes a value-based transformation, the focus shifts to improving patient experience, enhancing quality, and moderating costs. This approach is particularly crucial for geriatric patients, who consume disproportionate health care resources.

For Delaware seniors, meaningful metrics include:

• Functional independence measures (mobility, activities of daily living)

• Reduction in potentially inappropriate medications

• Decrease in avoidable hospitalizations

• Care coordination across multiple providers

• Quality of life assessments

Benefits for Delaware Stakeholders

Businesses benefit when employees aren’t absent caring for elderly relatives. Value-based geriatric models that emphasize care coordination and preventive services reduce this burden. For nonprofits, these models create partnership opportunities to address social determinants of health, like transportation and nutrition, that significantly impact outcomes but fall outside traditional medical care.

For policymakers concerned about health care costs, the imperative is clear. According to Delaware’s fourth annual Benchmark Trend Report released in May 2024 (1), per capita health care spending in the state increased 6.3% in 2022 to $9,657, far outpacing the target 3% growth rate benchmark. Value-based geriatric care models offer a path to bending this cost curve while improving outcomes for a vulnerable population.

By redefining how we measure success in elder care, Delaware can create a more sustainable, effective health care system that serves seniors with dignity while controlling costs—a win for patients, providers, businesses, and taxpayers alike.

1. Delaware Health and Social Services. DHSS Releases Fourth Annual Health Care Benchmark Trend Report.” May 7, 2024.

Karen Marie Joswick, MHA, is president and CEO at Benevolence Health