"By 2025 the number of Medicare beneficiaries will have grown from the current 54 million to more than 70. One out of every five Americans will then be enrolled. This will be the most rapid beneficiary expansion in history. Second, experts predict that by 2020, almost half of all Americans will have acquired a chronic illness, such as diabetes, cancer, and heart disease.... Third, the challenge is not only in the numbers of beneficiaries but also in their geographic location. A significant number live in rural and isolated areas where physicians and other caregivers generally do not. Finally, policymakers will be forced to address the cost of Medicare in the coming years."