We face a ‘silver tsunami’ and its accompanying health care costs


It’s no secret that the baby boomer generation has influenced this country in areas from pop culture to politics and the economy. The latest ripple effects are set to reach Vineyard shores, as our population of senior residents will increase significantly in the next five to 10 years — a silver tsunami, if you will. And the stresses that will be placed on the Island’s health care system should top the list of priorities we’re considering now.

This is one of the central forces driving the Vineyard Nursing Association’s capital campaign to raise money to buy the building at 15 Merchant’s Court in Vineyard Haven. As the only nonprofit homecare agency on the Vineyard, we are acutely aware of our responsibility to the community, whether providing physical therapy after knee replacement or providing housekeeping to elders, allowing them to remain at home. By buying the entire building, a portion of which we currently occupy, we will be able to expand services, add staff, and, in essence, secure our ability to meet Islanders’ needs both today and in the future.

It’s no coincidence that the new healthcare reform law is attempting to rein in costs at this particular time by reducing Medicare reimbursements to providers like the VNA. We have a very simple calculus that shows that, starting in January of 2011, the first baby boomers will turn 65 years old. They will, consequently, put pressure on the Medicare system for the next 17 years. In addition, more and more people choose to retire to Martha’s Vineyard for all or a significant part of the year. The result gives our Island a population of 65-plus residents that is growing faster than the national average and faster than the rest of Massachusetts.

If that is not enough, Medicare seeks cost-effective ways of treating people with chronic diseases — people who are not homebound and who, under the present guidelines, cannot be treated or monitored by homecare agencies. The thinking by Medicare officials is that if homecare agencies can monitor these people regularly, then homecare professionals will be able to prevent their being admitted to emergency rooms. Emergency rooms are where cost of treatment tends toward the exorbitant, and a patient’s stay is often brief. So individuals in these kinds of cases go home with a high likelihood of returning to a hospital when their conditions, unmonitored, deteriorate again.

As it stands, the number of visits made by the VNA staff has risen sharply in the past five years, climbing from 16,000 to more than 34,000 per year. We’re fortunate that, so far, we’ve been able accommodate the community’s increasing needs in relatively straightforward ways — namely, by increasing our staff twofold.

But adding employees to the VNA will not be enough in the years ahead. In addition, we will need more services, more training, more education — and more space to do it all in — to keep our community members living longer at home, while maintaining their safety and dignity. We never want to be in a position where we cannot meet all of the homecare needs on the Vineyard. The VNA has always answered the call when there was more for us to do. The community has always supported us in these efforts, and we are very grateful. Now, we need your help more than ever.

Bob Tonti is the chief executive of Vineyard Nursing Association.