In 2030, when the youngest of the baby boom generation will have reached the age of eligibility, the total number of Medicare enrollees is expected to reach 81.5 million, up 27% from 2020's 64.3 million.(1)
Dave Rich, CEO of Ensurem, a Florida-based insurance technology and product distribution firm, says, "This wave of baby boomers, whose needs and expectations are significantly different from those who came before them, will place a significant strain on the resources of the U.S. healthcare system. Healthcare providers and the health insurance industry need to be making plans now to assure that they can meet the needs of this enormous cohort of new Medicare enrollees."
The baby boom generation, people born in the post-World War II era between 1946 and 1964, represents 21.19% of the population of the United States.(2) While this generation has longer life expectancies and a much lower rate of smoking than previous generations, obesity is highly prevalent, as are chronic diseases such as hypertension, high cholesterol, and diabetes.(3)
Baby boomers are also likely to be more informed about available treatment options and Medicare services, leading to more informed decision-making and more effective use of healthcare resources. A striking example of this, notes Rich, is the widespread adoption of telehealth services that has taken place during the COVID-19 pandemic.
While there is broad recognition that telehealth services have helped provide access to necessary care, less attention has been paid to an underappreciated statutory provision. Unless it is repealed or amended, Section 1834(m) of the Social Security Act will prevent the continued use of telehealth services for all but a small number of Medicare recipients once the COVID-based health emergency has come to an end.(4) Ensurem, says Rich, joins with its partners in the health insurance industry in urging prompt Congressional attention to this issue. "It is," he says, "an important way to do more with less."
In addition to the pending enrollment of more than 17 million new Medicare recipients, notes Rich, an important reason to do more with less is continually increasing medical costs, driven by factors such as fee-for-service billing, the rise of chronic illness and obesity, lack of cost transparency, and skyrocketing pharmaceutical costs. (The median cost for generic prescriptions rose 37.6% from 2015 to 2019.) Insurance carriers, forced to control costs to provide wide coverage, find themselves limiting the number of plans in their portfolios and the number of provider networks within each plan.(5)
Ensurem, says Rich, essentially exists as a way for seniors to navigate the maelstrom of choices of the increasingly complex industry of Medicare insurance, particularly Medicare Advantage and Medicare Supplement coverage. Acting as a consultant to insurance shoppers, it seeks to identify a given client's specific coverage needs and match them to the lowest available premium. So far, Rich points out, Medicare-eligible baby boomers only include those born in 1956 or earlier. Now, he says, is the time to prepare for what we know is coming by making the most of recently available technology and addressing cost and efficiency issues.
"Our healthcare-for-seniors system is about to be tested as it has never been tested before," Rich says. "It is incumbent on everyone with a role in that system to make certain that the seniors of the baby boom generation, in all their millions, are properly cared for."
Ensurem, headquartered in Clearwater, FL, is a leading technology and product distribution company serving carriers and consumers within the massive U.S. senior market. The company provides end-to-end solutions for carriers, including product development, digital marketing, and consumer-centric front ends and back end. For more information, please visit Ensurem.com.
1. "Projected Change in Medicare Enrollment, 2000-2050." KFF, 12 Mar. 2013, kff.org/projected-change-in-enrollment-2000-2050-medicare/.
2. Investopedia Team. "Baby Boomer." Investopedia, Investopedia, 9 June 2021, investopedia.com/terms/b/baby_boomer.asp.
3. "Report to the Congress: Medicare and the Health Delivery System," Medicare Payment Advisory Commission, June 2019, medpac.gov/docs/default-source/reports/jun19_medpac_reporttocongress_sec.pdf
4. Thomson, Kyle. "Congress: Act Now To Ensure Telehealth Access For Medicare Beneficiaries: Health Affairs Blog." Health Affairs, 10 May 2021, healthaffairs.org/do/10.1377/hblog20210505.751442/full/#:~:
5. Miner, Josh. "8 Reasons Health Insurance Costs Continue to Rise." Hassle-Free Health Benefits, PeopleKeep, Inc., 7 Dec. 2020, peoplekeep.com/blog/8-reasons-health-insurance-costs-continue-to-rise.