1. Imagine you are a member of the demand planning staff for a hospital in a rural part of Florida. How would you begin developing a plan for the future demand for health care at your hospital? What demographic and other factors would you consider critical to developing such a plan?

2. Research some of the provisions in the Affordable Health Care Act (officially Patient Protection and Affordable Care Act of 2010, P.L. 111-148). Give one example of how the act’s new regulations will affect demand forecasting and planning.

The United States faces many challenges when it comes to predicting the demand for health-care services. Nowhere is this truer than in rural settings. Many senior citizens are concentrated in rural areas in the temperate climates of the South and the West. As the U.S. population ages, its health-care needs increase dramatically. For example, citizens who are 75+ years of age are four times more likely to require in-patient health care than are people 55 to 64 years of age, according to the National Center for Health Statistics. The problem is exacerbated because the overall health of Americans is declining as a result greater inactivity combined with poor diet. A larger percentage of the rural population displays these at-risk behaviors, which include alcohol and tobacco use, inactivity, and obesity, when compared with the urban and suburban populations. These risk factors are, in turn, linked to chronic illnesses, such as diabetes, heart disease, and cancer, which account for nearly 75% of all health-care spending.

Another factor that plays a role in trying to predict future demand for rural health care is the decline in the support of a cohesive family unit. With senior citizens living longer and family members increasingly mobile, they are unable to provide care. This lack of support network will shift the duty of providing care from the family unit to health-care organizations. Finally, the demand for in-home and community-based services, such as assisted living and adult day-care services, is expected to rise.

In this setting, government and health-care providers are trying to anticipate future demand for services to support older people. Rural hospitals, for example, will have to create a coherent long-term strategy to stay profitable. Among the issues they will need to focus on are:

Health provider recruitment and retention.

How will health-care organizations acquire and retain family practice physicians, surgeons, nurses, and other health-care professionals, especially in rural settings, which may not be as attractive to health-care professionals as larger cities or population centers?

Cost-effective treatment for the uninsured and under-insured.

Rural populations include a large number of people without medical insurance or ready access to health care. Although health-care organizations are morally obligated to treat these underserved groups, they represent a financial drain on hospital resources.

Community economic development.

Health-care organizations have a vested interest in supporting local economic development because the influx of new businesses (and jobs) tends to decrease poverty rates and the number of uninsured in a geographic area.

Expanding senior services.

Seniors will need more than traditional ambulatory and hospital care. How will health-care organizations address the demand for in-home and community based options in a cost-effective manner?