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What Will Aged Care Look Like in 2030?

Views are my own.

The year 2030 is a big deal at UnitingCare. It’s the year that our enterprise strategy, released in 2019, has identified that UnitingCare delivers on its bold vision. By the year 2030, we will be ‘Australia’s most trusted and respected health and community services provider…. And globally recognised as a leading light in care model innovation for ageing people.’

A large part of our team’s time is therefore spent thinking about how the landscape of aged care will change nationally and internationally over the next 10 years, so that we can begin building an organisation that both caters to (and indeed helps shape) this new world.

Here are some of our big predictions for what ‘Aged Care’ looks like in 2030.

1. Forget what you think it means to be old. Only 35% of people over the age of 75 consider themselves “old”. Products and services that market themselves to stereotypes have an expiration date on them. The “needy/greed dialectic” will crumble (“walkers, medications, and pill-reminder apps on one hand, and cruise ships, booze, and golfing green fees on the other”).

New narratives are being written; ones of empowerment, of individuality, and of the freedom (or dignity) to take risks. One of the hallmarks of marginalisation is that it flattens and binds; stripping its victims of their individuality and lumping them all together (in this case, as the ‘old’). Huge shifts are coming, brought about by the ageing of a high-net-worth, hugely powerful, and technologically literate generation.

Over the next 10 years, diverse new narratives will be written about the third act; we will see the late-stage entrepreneur, those that want desperately to give back, those that take on systems change, and those who want to #hustle until they drop. These narratives will be as rich and varied as the lives of the people they contain, but all will start with a reclamation of power. The amount of new products and services that will proliferate along with the rewriting of this meta-narrative is staggering (think as diverse as custom athleisure-wear, targeted higher education, co-working, prophylactics, hearables).

2. Forget ‘institutional’ aged care. Think of a locked hospital-like setting with 60+ residents, complete with the hums, whirrs, and beeps of equipment, where medication-trolleys crawl the floors, hand sanitizers and sinks line the corridors, showers and meals happen at the exact same time every day, husbands and wives are housed in separate rooms, and activities and menus are decided weeks in advance. This is, for the most part, how Australia continues to operate its residential aged care services.

There is a new model, already popular in Europe, and growing in popularity in North America, that looks very different. Here you share a room with your partner, wake up in a house of 6 or 7 like-minded housemates, prepare yourself the breakfast that you’ve had all your life, and begin planning what you’ll do that day; outings and transportation are offered, but how you spend your time is up to you.

Think of the ageing of your parents, of a relative, of somebody you love, or of yourself; then ask which one of these models is the more natural, the more humane, the more likely to gain ascendancy?

The ability (or inability) of incumbents to healthily disengage from the traditional model and move themselves to a new model will be one of the key determinants of their success in 2030. As will their effectiveness in the delivery of services in people’s homes. Indeed, healthcare as a whole needs to move this way; over the past 20 years, Denmark has cut its number of hospitals by 2/3rds.

3. Power to the people! When the Aged Care Royal Commission released its interim report in late 2019 the commissioner noted: “Despite appearances, despite rhetoric, there is little choice with aged care. It is a myth that aged care is an effective consumer-driven market”. In a world where increasing customer expectations, better technology, and more competition are supposed to be moving us toward ever-higher standards of service, there are still some legacy peculiarities that hold the aged care market back.

Over the next 10 years, we expect the following dramatic changes:

No more information asymmetries. Reviews are on the rise, and aged-care is far less of a gamble now than it was a few years ago. Expect this trend to continue, and providers to begin to seriously compete on customer experience. Expect to see many more news articles, Tweets, Facebook status updates, Instagram posts etc. from those receiving aged care services (great, terrible, and in between). The Canstar or Choice of Aged Care is not far away (there are a few services already trying to play this role, but there is not yet a critical mass of public information/reviews available.)

More platform players: As with the majority of service industries, aged care too will have to contend with platform players. Platforms are typically able to put more control in the hands of customers, charge users less, pay their staff more, and extract more consistent margins. This ability to run very lean means they are able to offer more service per dollar (given the majority of aged care is still government funded, this metric is likely to be one to watch).

We’ve seen explosive growth (off a low base) of some platforms in the aged care and disability space over the last 5 years:

  • Hireup: 7,173% growth in 2015 (disability services).
  • Mable: 300%+ growth in 2018 and recently closed a $15m funding round.
  • Five Good Friends: 178% increase in visits in 2018 and recently finalised a $5m funding round.

Legislative and economic policy trends obstinately towards ‘consumer-directed-care’: In aged care today switching costs are prohibitively high, competition is low (or non-existent) in some geographies, and block funding is still in operation for some funding types. We expect the government to use all available levers to attempt to rationalize the industry. We know that shifts away from block funding are coming, only the timelines are uncertain.

Originally published at https://medium.com on February 24, 2020.

A team of pokers, prodders and pushers redesigning the future of care.