5Largest Impacts Coming to Aging-inPlace Market

What industry insiders should know

BY JILL BARBARO

The “Boomer Retirement Wave” began in 2008 and will culminate in 2031 at which point more than 20% of the entire U.S. population will be 65+ and, according to a 2021 survey conducted by AARP, more than 80% of them will want to stay in their homes as they age.

More than halfway through this demographic shift, limited steps have been taken to address retirees’ desires and the pressing need to bolster the aging-in-place model from a financial perspective (for retirees and the healthcare system at large). To make aging-in-place commonplace, AEC professionals will be in high demand and will experience abundant revenue opportunities that will simultaneously improve the healthcare system and lives of older adults.

In April of 2021, President Biden outlined his American Jobs Plan, pledging $400 billion toward improving homecare, which was in some ways a recognition of the lagging investment in, and focus on, this space. The apportioned amount announced could fundamentally change the aging-in-place market by increasing wages for homecare workers, which could start a virtuous cycle of workforce stability, investment in employees and continued job/wage growth.1

This cycle would increase the supply of homecare workers and thus homecare services. Since the original form of the bill, the proposed investment has been scaled back to $150-$190 billion, which according to a report in The New York Times, jeopardizes the intended wage increases.

However, there is already forward momentum toward progressing homecare after the COVID-19 pandemic highlighted the inadequacies and downright dangers of institutional living and created temporary programs that expanded homecare options. The COVID-era programs empowered private coalitions of some of the largest names in healthcare to form and lobby for the creation of widespread, permanent homecare programs with governmental reimbursement (i.e. Moving Health Home Alliance lobbying for payment reform for homecare services and the Advanced Care at Home Coalition for permanent status of hospital-at-home programs).

Experts have cited $250 billion as the level needed for the investment not to fail, and with these groups to back the effort, it is well within reach. As the barriers to homecare fall, care at home will increase across the entire continuum from home health aides who assist with activities of daily living and allow seniors to age in place to have highly skilled, acute care in the home. Here is what you should know to prepare for this coming change:

Barriers that have stopped seniors from getting care at home include a payment structure that favors institutionalized settings, a lack of technology and processes to monitor clinical status and engage patients at home, and homes that are not well equipped for senior living. Reforms in these areas could be funded by savings from moving patients from skilled nursing facilities and acute care facilities to the home.

1) Greater demand

The need for accessible housing is going to increase. While 90% of housing units in America have at least one aging-accessible feature, according to U.S. Census data, less than 10% are safe for aging in place. All over the U.S., there will be a burgeoning demand for renovation work to transition homes to aging-friendly spaces. This will also translate to a greater need for newly built, aging-friendly houses in regions where the stock of these homes is comparatively low and the cost to renovate is prohibitive due to home age and layout (i.e., Northeast and Mid-Atlantic).

2) Future partners

While creating aging-safe and accessible homes will be essential to address the final barrier to homecare, for many individuals the cost of renovating will be out of reach.

For architects and contractors in the industry, forward-thinking integrated delivery health systems and vertically integrated payor organizations may become unexpected partners in business to address this gap. Those that prioritize population health or are truly looking to deliver the most impactful care at the lowest cost may contract with you directly to improve their patient’s homes.

3) New regulators

As care is moved to the home, Certificates of Need no longer apply, but you can expect that someone will create standardized definitions of

What It Means

for a house to be “aging-safe” or suitable for hospital-at-home.

Today, these standards are likely determined at the organizational level or through nonprofit certifying organizations, but with Medicare and Medicaid being pushed to cover these services, a governing body who will create widely accepted standards to adhere to will emerge.

4) Incorporation of digital Remote-monitoring technologies will continue to proliferate. This is a trend that has been seen for years and can be credited with allowing the opportunity for care at home. As digital tech expands and becomes even more ubiquitous, it will be important to examine: a. How new products can be incorporated into housing design to create next-level, aging-safe spaces. b. How to incorporate directto-consumer products into care plans, while still maintaining a safe and consistent experience for all patients.

5)

will solve problems and create new opportunities. In most areas, greater demand will make businesses more efficient through economies of scale: think of services like Amazon Flex, Uber and Lyft. When the distance between clients is minimized, individual contractors can be more fully utilized. In the coming years the opportunity will arise to think critically about how to most impactfully schedule patients (i.e. by employee drivetime, task, acuity, etc.) and examine any tasks that can be performed remotely through new digital tech capabilities. Together, these solutions can create efficiencies and reduce costs. The conversations happening across the nation today are going to break down existing barriers and allow individuals to safely age in place. Organizations focused on serving those looking to age in place who demonstrate creativity, flexibility and forward thinking will find endless opportunities to grow their businesses and improve the lives of customers.

1https://array-architects.com/wpcontent/uploads/2021/04/5-KeyQuestions-Around-Bidens-Home-CarePlan-White-Paper1.pdf

Economies of scale

For businesses that employ homecare workers, the increasing demand