The rapid pace of change in healthcare today is the new normal. Perhaps nowhere is that reality truer than in the senior care industry.
Driven by an aging population of baby boomers and accelerated by technology and shrinking reimbursement models, senior care offers clinicians significant opportunities and notable risks. Physician associate (PA) and nurse practitioner (NP) entrepreneurs must navigate this sea of change to succeed.
Kevin Riddleberger, PA-C, MBA, is uniquely poised to advise PAs and NPs on how to thrive in the evolving senior care industry. He has 20 years of clinical and healthcare management experience and co-founded DispatchHealth, a tech-enabled, care delivery company delivering high acuity care in the comfort of patients’ homes. Riddleberger has a knack for seeing care gaps as opportunities for growth.
Opportunities in senior home health
The senior population often experiences unnecessary and costly emergency department (ED) visits. Many elderly ER visits are deemed avoidable, which leaves an immense care gap where NPs and PAs can provide high-quality, cost-effective care.
In 2013, Riddleberger and his team at DispatchHealth saw this gap as an opportunity to provide better, more efficient care to the senior population. By partnering with 911 emergency services, they could send NPs and PAs to the location to treat non-urgent patients. “We saw an amazing opportunity to deliver value to the payer, provide an amazing experience to the patient and coordinate that care back to the primary care provider –– all while being a connected piece to the whole ecosystem,” says Riddleberger.
Combining technology with expert care from PAs and NPs was relatively new at the time. Like everything in healthcare, the pandemic accelerated technology use and different models of care.
Today, there remain significant opportunities for home-based care models leveraging advanced practice providers’ clinical expertise. “We still have cost and utilization problems in the United States. Too many people are going to the ER, the hospital and skilled nursing facilities for unnecessary reasons. That’s where there’s opportunity for technology to help deliver the right level of care needed to treat these patients effectively in the home setting,” says Riddleberger.
Whether over telehealth or through mobile teams, this acute and chronic care delivered outside the hospital is better for everyone. Beyond cost savings, patients experience more comfort and satisfaction when treated in familiar environments.
Technology advancements shaping the future
Integrating advanced technology, like wearables, telehealth and AI-driven clinical decision support systems, holds immense potential for all care areas. Technology can help the growing senior population maintain independence for as long as possible.
“The geriatric population wants to age in place. PAs and NPs can provide that through technology with the right provider at the right time,” says Riddleberger.
To make it easier for seniors to stay healthy, technology companies are designing user-friendly tools tailored specifically for this audience, reducing adoption barriers. “These platforms aren’t not built for a 25-year-old and then adapted. It’s purposefully designed to meet this population’s needs,” says Riddleberger.
PAs and NPs are a key part of how senior care technology platforms work, which opens up opportunities for PAs and NPs to work remotely in the gig economy.
Emerging risks in senior care
Home-based care and delivering care through digital platforms carry inherent risks that differ from direct care in a hospital or clinic. Riddleberger outlines three of them.
Reimbursement risks:
Medicare reimbursement is continually evolving. Getting paid for geriatric healthcare means staying current on coding and demonstrating clinical efficacy.
Policy risks:
Working in an area of healthcare that depends on Medicaid or Medicare comes with policy risks. Congress is considering some $80 billion in cuts to Medicaid over 10 years.
Clinical and malpractice risks:
Delivering healthcare outside traditional settings increases exposure to clinical and malpractice risks. Collaborate with your malpractice carrier so they understand the type of care you’re providing and get you adequate coverage. In addition, having the right quality assurance and improvement program ensures you constantly learn and improve.
Riddleberger also recommends implementing rigorous clinical protocols and getting them endorsed by your malpractice carrier. Also, establish comprehensive quality assurance and improvement programs for when an issue does arise.
Enhancing education and certification
Succeeding in healthcare today requires embracing and adopting new technology. Continuing education and certifications specifically designed for NPs and PAs help them learn about new technology opportunities that elevate the quality of care and significantly reduce clinical risk. “NPs and PAs need to be able to pick the right technology platforms to augment your practice, whether it’s in a traditional brick and mortar practice, telehealth or mobile care,” says Riddleberger.
Stay up to date on coding and compliance
Getting paid in senior care means adapting to constantly changing reimbursement rates and coding. “Reimbursement challenges will continue to exist. You need to collect the right data to demonstrate the care’s effectiveness and even advocate against policy changes for the Medicare beneficiaries you serve,” says Riddleberger.
The good news for senior care’s future
Despite its challenges, senior care delivery holds significant promise. Innovations born from necessity during the pandemic have established home-based care as mainstream. Coupled with ongoing technological advancement, the opportunity to deliver exceptional, personalized senior care is growing.
For PA and NP entrepreneurs willing to adapt and innovate, the future of geriatric care presents significant opportunities to improve patient outcomes, enhance healthcare delivery and build thriving, impactful businesses. “I’m very optimistic about what technology is doing to enable clinicians to do more with less. There are many great things ahead for healthcare,” says Riddleberger.
