I am particularly happy to see younger case managers at the annual conferences these past several years. Not long ago, I only saw my own age group, and it made me very nervous. In the July/August 2018 Editorial, the statistics explained the reason for this trend: the aging of the case management workforce. In 2009, 21% of case managers were older than 55 years; but in 2014, that percentage more than doubled. According to the Role and Function Study from the Commission for Case Management Certification (CCMC), nearly half of the respondents (46.91%) were between the ages of 51 and 60 years, with the largest age group being 56-60 years (24.69%). Another 14.3% were 61-65 years of age, and 4.7% were older than 65 years (Tahan, Watson, & Sminkey, 2015). Now, in 2019, add a few years to these statistics; where do you fit in?
This is certainly one way that "age" is shaping health care. But with the younger generation, it behooves us to understand the nuances of what is deemed important to each age group. As health care changes, and with customer service being factored in, the preferences of each age group could (and likely will) change health care. So for this Editorial, the National Case Management Week topic is about the role "age" may play in our roles as case managers. According to the Advisory Board (2017), there are significant differences between the various age group-no surprise-but seeing these various priorities is enlightening. Millennials, Gen X, Baby Boomers, or the Silent Generation all consume care differently. The Advisory Board surveyed thousands of consumers across the United States to better understand their care expectations. It segmented the surveys by four age groups to help health care companies target their messages to different generations (Advisory Board, 2017).
Age Group 18-29 Years Old
* 54% preferred after-hours access. This group is the least loyal, and referrers were the most likely to switch primary care physicians (PCPs). They were also the most likely to leave for a new (better) competitor's offering.
* 33.9% of self-referrers in this group indicated that they broke a referral to see a specialist of their own choice. They were also the most likely to find a provider online.
* This age group is the least concerned about traveling for surgery. Perceived surgeon quality, hospital affiliation, and a referral (from a friend?) determine more of their surgical decisions than other age groups.
* 67% would consider a virtual visit if in-person care is unavailable that day; 20% would consider a virtual visit if it was less expensive than an in-person visit.
The Bottom Line of This Age Group
This digitally fluent group is the most socially connected generation. They are the most likely to read reviews and compare prices to find providers offering maximum convenience at the lowest cost. They are also the most likely to shop for providers and write reviews online.
Age Group 30-49 Years Old
* A free visit topped this group's list of priorities. This group was more likely to leave their PCP because of a $250/year care cost increase than experiencing a medical error.
* 17.9% of self-referrers in this age group received a specialist referral but still shopped for care instead of blindly following it.
* Travel is not make or break for this group; it factored less in their decisions than costs but was still nearly three times more important than perceived surgeon quality.
* 73% would consider a virtual visit if in-person care is unavailable that day.
* 47% would consider a virtual visit if it was less expensive than in-person care.
The Bottom Line of This Age Group
These are the health care decision influencers. They often direct-not only their own care but also that of their partners, children, and aging parents. This "sandwich generation" needs care to fit into their busy schedules and will use nontraditional hours and virtual options.
Age Group 50-64 Years Old
* This group might pay more for access and convenience: Time to first available appointment and ancillaries on-site outranked a free visit.
* Experiencing a medical error was more likely to make this group leave their PCP than a $250/year care cost increase.
* 7.5% of self-referrers in this age group did not follow their doctor's referral fora specialist; they shopped for a specialist of their choice.
* This group is disinterested in traveling for care and was the most cost-sensitive of the age cohorts when it comes to surgical care.
* 62% would consider a virtual visit if in-person care is unavailable that day; 32% would consider a virtual visit if it was less expensive than in-person care.
The Bottom Line of This Age Group
Increasingly delaying retirement, this group is staying active and engaged in personal wellness longer than before. Often managing multiple chronic care conditions, these consumers expect timely access to in-person care.
Age Group 65 Years and Older
* Provider continuity and credentials were more important than a free visit.
* The 65+ cohort is the most loyal-They were the least likely to leave their PCPs and also the most likely to recommend their providers.
* Only 7% of these self-referrers reported breaking a referral to see a provider of their choosing.
* Hospital affiliation was most important in this cohort's specialist selection.
* This age group does not want to travel for care-Travel time was more than twice as important as following a referral or hospital affiliation to this group.
* 58% would consider a virtual visit if in-person care is unavailable that day; 20% would consider a virtual visit if it was less expensive than in-person care.
The Bottom Line of This Age Group
These are health care's traditionalists: They are the most loyal age group, least likely to break a referral, and disinterested in traveling for care. However, as the Baby Boomers age into this age group (from the 50-64 years age group), they will alter the profile of the 65+ consumer group to more resemble some of that group's priorities.
So how will this change a case manager's work life? Although these are just examples, and crystal balls are hard to come by, these are just a few of the changes that may be due to age preferences.
* Different and expanded hours: There was a time, for example, that hospital case managers worked primarily Monday through Friday. Now most large facilities have near 24/7 coverage.
* More tele/virtual medicine: This can be for clinical and/or social assessments.
* More international case management: As patients are more willing to travel to their health care destinations, travel case managers may be needed.
We all know that the only certainty is change. And sometimes anticipating the change makes it less scary. At any age, Professional Case Management journal honors its case management colleagues, during this National Case Management Week-and always!
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