Rose Maljanian is the founder and CEO of HealthCAWS, a privately held corporation focused on improving health and making healthcare more affordable. Throughout her career, Maljanian has served on the frontlines of health innovation as SVP for Product Innovation at Magellan Health Services, a senior member of the Innovation Center leadership team at Humana, and as the founding director of Hartford Hospital's Institute for Outcomes Research and Evaluation. Here, she enhances her earlier composite of the new healthcare consumer with a focus on the needs of seniors and how best to reach this population. Innovators, she argues, must understand and appreciate seniors' needs for 8 key qualities: mobility, a modern experience, options to stay at home, better service, transformative tech, connectivity, value, and personalized goals:
In my recent post, Meet the New Healthcare Consumer, convenience, ease of use, and value out were among the themes. No particular consumer group, gender, or age range was mentioned and that was by design. These themes apply across the board - not just to young, tech-savvy consumers. Due to roughly 4 million new boomer consumers aging into Medicare each year and the old stereotypes often miss-assigned to the elderly, the growing need for solution providers to address today’s seniors from a place of true understanding presents an undeniable opportunity.
This message hit home for me on a routine trip to the airport, except it was winter and my flight from New England to Florida included nine seniors in wheelchairs. I watched in amazement as an airline staffer pushed them one by one down the jetway. Most of the other passengers were grumbling as it became clear that the chance of this flight leaving on time was next to none. I sat back and smiled as I thought to myself, these are the new generation of seniors, they are not staying put and certainly not rushing to check into a nursing home.
2) A modern experience
When providing or innovating healthcare services for seniors, it is important to understand their journey - what they have seen in the past, where they are today, and how they want to live out their last decade(s) or days. The average senior consumer was old enough to remember the nursing home environment of the 70’s and 80’s where their relatives and family friends may have been restrained and medicated by well-intentioned staff that just wanted to keep them safe. The unintended consequences of such confinement was robbing individuals not only of their dignity, but also worsening their health due to complications and spending down their life savings to be in an environment they didn’t choose. Today's seniors vowed it would be different when they reached their own golden years.
3) Options to stay at home
Thankfully restraints and inappropriate sedation are much less common today and in some states allowable only in extreme cases where harm to self or others is imminent and not otherwise avoidable. And despite efforts to create environments that are less restrictive, more homelike, rich with activities and amenities including chef-prepared meals, many seniors (65+) and pre seniors (45-64) are voicing the preference to stay at home with support as long as they can. New approaches and technologies including assistive devices, creative staffing for homemaking and self-care, remote clinical visits and monitoring, and tools to help with complex medication regimes are making this goal more sustainable, as well as enabling a smoother transition to assisted living or long term care when they are ready.
4) Better service
Many advocacy groups including the National Council on Aging (NCOA) are fighting to erase the stereotypes that have created ageism bias and equipping seniors with knowledge and tools to successfully manage their senior journey. In addition to the desire to age with dignity at home, an educated and empowered senior consumer will demand dignified care, expecting to be seen by informed, courteous staff and on time, when they are scheduled. Today’s seniors do have better things to do than sit around a doctor’s office or diagnostic testing facility all day and will share their experiences in surveys that can impact Medicare star ratings and other key reviews.
5) Transformative tech
When it comes to technology, don’t rule this group out. This is the generation whose grandparents and parents embraced transformative changes in electricity, television, cars, and air travel, and most like the convenience that the internet, cable television, microwaves, and cellphones have to offer. A PEW Research Center survey demonstrated already by 2012 a rapid increase in internet use with more than half (53%) of seniors age 65 and older online; of those online 70% use the internet as part of a typical day compared with 82% of all adults using the internet using the internet in a typical day. Plus findings that 69% of seniors have a mobile phone and 1 in 3 of seniors online use social networking such as Facebook or Linkedin. By release of a similar report in 2014, PEW noted that in just about a year the numbers continued to rise with 59% of seniors going on line, 47% having high speed broadband use, and 77% having a cellphone. While the flip side represents the seniors left out with more work to do, the progress to date is encouraging.
When it comes to staying connected to loved ones, these seniors have embraced videoconferencing to see grandchildren and friends and are making new relationships online. Humana, a leader in the Medicare Advantage segment, documented this phenomenon in a 2012 study performed by a third party in which nearly 50 percent of grandparents agreed technology has brought them closer with their adult grandchildren; 20 percent of grandparents said they use Facebook to keep up with the profiles of their grandchildren on a regular basis; and younger grandparents (ages 65 – 74) were twice as likely as older grandparents to check in with grandchildren using this technology. The motivator is obviously the grandchildren in this case, but once technology is learned, we can see that if we keep it simple, these tools can translate well in healthcare to further accelerate the use of remote monitoring, electronic clinical and social needs check-ins, or digital healthcare visits.
Like with any other group, it is important to recognize where on both the health and the spending continuum each individual sits. For some every dollar and penny matter in their ability to make ends meet. A fixed income with growing health issues may be chewing up 100% of what would be their disposable income or they may require public assistance and community support programs to have an equal shot at living in their homes as long as possible. Other seniors have paid off their houses, inherited money from the previous generation, and have the dollars to spend to stay in their homes, hire support services, or sell their homes to opt for senior resort-style living. These seniors, according to a recent Bloomberg story, account for approximately 70% of the overall disposable income consumers spend, creating a very large market for innovators to address. On a cautionary note, while there may appear to be money to burn, this is not the generation who grew up paying $4-$5 a day for a double mocha latte on their way to the office. Value out in terms of what they value for the dollar spent cannot be overemphasized.
8) Personalized goals & plans
When providing direct care services and innovating new solutions, don’t assume we know the answer to what equals value. Talk openly and ask seniors what their goals are, particularly important when it comes to end of life issues and advanced care planning. You may be surprised at what you hear. Take a recent story about a 90-year-old woman named Norma. Norma was recently diagnosed with ovarian cancer two days after her husband had passed away. She decided to forego medical treatment and instead go on what she deemed a trip of a lifetime with her family visiting national parks and monuments across the country. A picture’s worth a thousand words so look at Norma’s face and decide for yourself if Norma made the right choice. Seniors, and sometimes along with the loved ones that know them best, will make the right choices for themselves when empowered with information and options.
Rose Maljanian Chairman & CEO, HealthCAWS