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The U.S. healthcare system faced steep challenges in providing effective care and outcomes to older patients even before the COVID-19 pandemic hit. Now, the stakes have become even higher.

The virus outbreak has stretched U.S. healthcare systems unlike any crisis in the past, and exposed critical shortcomings of their business models that have built up over decades. These include an inability to provide care services during lockdowns and the prohibitively high cost of care, coupled with narrow penetration of health insurance among the elderly. The latter caused out-of-pocket expenses to skyrocket, thus discouraging patients from seeking care. A glaring lack of capacity to handle outbreaks didn’t help matters as COVID-19 infections spread. Filling these chasms will require new business models and technologies driven by a long-term vision.

However, like every crisis, this one has a silver lining. It forced providers to quickly expand their use of technologies such as telemedicine to manage the influx of patients and maintain care continuity. At a time when the healthcare sector was inching toward an on-demand model, the pandemic served as an accelerant for technologies such as sophisticated remote monitoring that make telemedicine, virtual and at-home care more effective and accessible.

For the elderly, this new direction, while intimidating, is the right way to go; on-demand offers remote access to diagnostics, doctor appointments, and primary care — immediately and at appreciably lower costs. But before on-demand can truly take hold, players across the care value chain must understand how the idea of aging has evolved, and must shape treatments and interventions accordingly.

COVID-19 has highlighted the crisis in elder care

Although older adults outspend all other demographics on healthcare, elder care in the U.S. has not kept pace with the steady growth of elderly patients.

High out-of-pocket spendingeven under Medicare plans, spurred by fewer people with private insurance coverage, makes some older patients less willing to go to a hospital to be tested or treated. Costs for COVID-19 treatments are also expected to be high for seniors. According to some estimates, out-of-pocket healthcare spending will rise as a share of average per capita Social Security income from 41% in 2013 to 50% in 2030.

Meanwhile, the U.S. market for home care, which is expected to grow from $100 billion in 2016 to $225 billion by 2024, is facing a shortage of registered nurses. This has wide-ranging ramifications for the system as a whole, but especially for the delivery of elder care. At a time when 80% of Americans have expressed a desire to live in their homes until they die rather than in a long-term care facility, these challenges may prevent healthcare providers from helping that to happen.

The pandemic has, unsurprisingly, pushed care providers to increase their spending on healthcare IT and reduce the timelines for digital implementation. But technology is just one side of the story. As the new healthcare landscape takes shape across the U.S., healthcare providers must restore consumer confidence that has been shaken by the pandemic. This will require an approach that is human-centric at heart and technology-driven in execution.

Transforming how elder care is delivered

By investing time and money to better understand the perspective of older patients and leveraging technology to improve care delivery, providers can transform the patient experience. Our study, “The Future of Aging,” found that contrary to some stereotypes, older adults are a vibrant, culturally savvy cohort with unique needs and desires. That study and much more research suggests that engaging with the elderly to understand them beyond their diets and exercise requirements will let caregivers design human-centric treatments delivered via the right technological tools.

Three levers: digital, platforms, human-centricity

Care delivery is undergoing a massive change, driven mainly by the need to expand access to care and greater tech adoption by providers in areas such as automation, cloud and mobile. As this transition happens, it’s becoming clear that the industry is slowly steering toward a platform-driven, on-demand business model (read our white paper, “Rethinking Health Plan Business Models for the Emerging On demand Digital Economy,” to learn more).

This model is ideally suited to the needs of the elderly. Apart from reducing the anxiety associated with visiting a hospital, this approach could make care less expensive for those who pay out of pocket.

Digital technologies can help build the necessary foundation: platforms that help virtualization of care at lower cost and with a human-centric approach. We recommend that providers take the following steps to become future-ready:

1    Accelerate digital adoption.

COVID-19 has shown how digital can be used to make care better and more accessible to the elderly. Early in the crisis, several academic medical care centers started using telehealth to remotely triage infected patients and even to monitor the sickest intensive care unit patients, highlighting the ready-made nature of telemedicine for providing advanced care remotely.

This underscores the need to accelerate the adoption of technologies, including cloud, machine learning and automation, that can expand the reach and accessibility of hospital care to the suburbs and rural areas. Importantly, the use of digital technologies had been growing among care providers even before the pandemic. Though telemedicine has surged in popularity since it is less popular among patients over the age of 55. The emerging field of gerontechnology holds promise in this regard.

2    Leverage emerging platforms for affordable and accessible care.

Enabled by digital, emerging business models promise to deliver primary care, diagnostics and other services closer to patients’ homes and at lower cost. Care systems that have embraced this approach have seen huge cost savings already. Direct-to-consumer lab testing, meanwhile, has gained popularity in the U.S, with COVID-19 heightening interest in this approach. How we see this newly realigned care delivery model is illustrated below.

Care providers can take different paths to achieve this digitization:

  • Emerging plug-and-play care platforms, combined with the emerging on-demand model, lets consumers select services as and when they need them.
  • Telemedicine, combined with artificial intelligence, will make anytime, anywhere care possible. This virtual care model allows caregivers and patients to reach out to one another as needed.
  • The McHealth model, based on the existing large retail model, promises to bring care closer to patients by establishing walk-in clinics that offer high-quality primary care at low cost.
  • Hospital as a service extends the reach of major hospitals, letting them share their research expertise with emerging McHealth model-based competitors.

Read our white paper, “Healthcare On Demand: New Provider Business Models for the Digital Economy,” for more.

The success of these business models, no matter how they are implemented, will depend on the quality of data they have access to. The interoperability clause, which came into effect in the U.S. recently, is a step in the right direction. In the near future, data previously stuck in silos could be used to identify and treat the most vulnerable patients. Similarly, health plans could receive historic patient data within minutes, allowing them to quickly determine which members need attention.

  Deliver human-centric elder care.

While technological advancements and new models can make care delivery faster and more reliable, putting this new reality to work for the elderly requires a different approach — a more human-centric approach, such as Instacart’s adaptive interface, which lets the visually impaired navigate stores. If we are to make the elderly more comfortable around technology, perhaps it’s a good idea to build care delivery around their needs. Based on our aforementioned research, we believe the following establish a good starting point:

  • The idea of an aging community needs to change from that of a nursing home to a more informal setting. Such informal systems play an important role in supporting healthy aging.
  • This, combined with the on-demand business model, can help the elderly become more self-reliant, as services are built around their needs.

Bringing Human-Centricity to Elder Care

Gerontechnology, a field that combines gerontology and technology, has emerged as a human-centric approach to adult assistance and elder care. This is a much needed change at a time when America’s senior demographic is projected to outnumber children by 2035.

Moreover, adult-assistance technology is a large and growing market. Consumers over the age of 50 are expected to spend $84 billion on technology by 2030 on tech that makes life easy, such as voice assistants, driver assistance, and virtual reality.

But the scope of senior-focused technology covers various aspects of elder patients. Examples are emerging:

  • The Hong Kong government has allocated HK $1 billion for research into how digital technologies can enhance in-home support, treatment and rehabilitation.

  • Technologies such as robot hands for treating degenerative neurological diseases are also being developed in Hong Kong.

Despite the rise in popularity of smart devices among seniors, their use of smart devices is undermined by frustration with new technology — which reflects a lack of user-centricity and a bottleneck for remote care.

Gerontechnology’s human-centric approach could be the key to unlocking the potential of modern technology to transform elder care. By ensuring older adults’ participation in the design and development of these digital tools, technologists can bring about a revolution in the field.


  • Static ideas of aging need to change. Older adults account for the lion’s share of discretionary healthcare spending. They also view aging not as a problem to overcome, but as a vibrant process to be embraced. To keep pace, care providers must rethink how they view this demographic.

The COVID-19 pandemic has served as an uninvited catalyst that showed the way forward for older adult care. With the right set of technologies, care providers can pivot to a more nimble, human-centric operational model powered by data-driven insights.

To learn more about the on-demand care model, read “Healthcare On Demand: New Provider Business Models for the Digital Economy,” visit our Healthcare Practice, or contact us.