Senior Housing REITs, Operators, Looking into ACOs

There’s been some buzz recently around the accountable care organization (ACO) model found within President Obama’s healthcare reform bill, as the senior care industry looks into partnering up with other providers in the continuum of care to provide the best possible outcomes for patients. Even though much of the bill won’t go into effect until next year or even 2014, some senior living industry executives are making moves to keep their companies in the loop.

During Brookdale Senior Living’s fourth quarter earnings call, CEO Bill Sheriff was asked if his skilled nursing facilities were seeing any incremental traction with hospitals to become a preferred partner for post-acture care services.

“We have very active dialogue and explorations and also several initiatives and pilots going on with different hospital systems,” Sheriff replied. “They are reaching out to us as we reach out to them and are getting traction, and people continue to focus on that.”

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Similar to Brookdale, Emeritus Senior Living is focusing on coordinating care in the acute and post-acute care continuum.

“It’s going to become important as part of healthcare reform where hospital systems are looking to partner up to a greater extent with post-acute services like skilled nursing, assisted living, home care, rehab– the environment is changing to outcome-based in terms of reimbursement,” Emeritus president and CEO Granger Cobb told SHN. “They want to make sure their patients, when they’re discharged, stay healthy and aren’t readmitted for the same diagnoses a couple weeks later. Having the ability to provide all of those different service offerings, and provide options for the seniors in terms of which setting is most appropriate and which they prefer in terms of meeting their needs—that’s important.”

REITs are looking into partnerships as well.

Health Care REIT’s president George Chapman said there have been conversations with the REIT’s senior housing operators and post-acute operators about hospital readmission rates, target goals, and plans to coordinate with acute care providers.

“We’ve done a lot of work just with our assisted living, senior housing and post-acute operators here in our headquarters talking about that very topic, as well as best practices and other ways to develop win-win situations and maybe even joint buying and other things like that,” said Chapman.

Chapman mentioned Health Care REIT’s relationship with a hospital/health system it has “done a lot of work with,” adding that one of its assisted living operators is building close by the hospital, while one of the REIT’s “top” post-acute operators is building “right adjoining the hospital.”

“There are ongoing discussions about how they can vet one another and to be prepared for ACOs, bundled payments, when they actually hit,” he said. “Everybody’s trying real hard to figure out how to do it and how to do it effectively, and we’ve been right in the middle of it and we’re hoping that our areas of concentration will continue to provide an opportunity for John Thomas and Chuck Herman and our people on both sides of the house and myself to foster more collaboration because frankly, even without stiff penalties being in place right now, there are some benefits for trying to deliver health care much more effectively and cost efficiently. So we’ve been very active in that area. And we’re starting to see a lot of really good collaboration developing.”

Written by Alyssa Gerace

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