Continuing Care at Home Models Add Insurance Benefit

Watch out retirement villages, there’s a new care model in town.

While the demographics are consistently strong for senior housing demand in the future—with 10,000 baby boomers turning 65 every day—the majority of adults want to age at home, and senior housing providers are starting to accommodate those who want to age in place.

Enter the continuing care retirement community (CCRC) at home. 

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With all the same service offerings as a retirement community, CCRC models that reach seniors at home provide a similar service experience without the community aspect. Operators have their own approach when it comes to expanding to their surrounding communities, but one provider has incorporated an insurance plan to boot.  

Meeting Needs at Home  

Goodwin House has found its footing as an established non-profit community in Virginia, serving more than 1,000 residents over two campuses. While the community has met its occupancy goals, executives recognized that spreading their mission to seniors who live at home could be an additional branch of the business. Thus, the birth of Goodwin House at Home. 

Goodwin House’s new program is not a home health agency. Instead, the model offers access and coordination among most of the services that are typically offered at a CCRC to a person living in his or her own home.

The idea is that Good House at Home will coordinate care as it becomes needed for those who enter the program with a membership and purchase a long-term care insurance plan.

The program works with a long-term care insurance policy, where older adults would be medically cleared to enter at a stage where they don’t need many services, but would like the security of knowing their needs will be met in the future. 

The added assurance that services will be available over someone’s life and provided in a senior’s own home is what makes this program stand out from a regular insurance policy—and differentiates the business from what a typical home health agency can offer. 

“The concept is new in this area,” Karen Skeens, executive director of Goodwin House at Home, told Senior Housing News. “It requires a lot of education because it has the continuing care component. If you think about any type of service that’s in the community that a senior could reach for—anything that you can think of that a senior might need as they age and start to need care—it’s all wrapped into this program.” 

By bringing the CCRC services into the home, seniors can live the way they want in retirement without worrying about health changes forcing a major disruption in lifestyle, Skeens says. 

“Goodwin House at Home is modeled after a lifetime continuing care community,” said Skeens. “It essentially works with independent seniors. We take coordinated services into their homes. This program works like long-term care insurance.”

When adults enter the program, they must be independent and must meet a set of health requirements that is stricter than moving into a residential CCRC. In addition, there are some pre-existing conditions that would preclude an adult from being eligible. At this point, a year into the program, those who have signed on still aren’t in immediate need of care services. 

“The concept is that we are providing insurance for them,” Skeens explained. “We’re not only providing the care, we’re paying for their care.”

Goodwin House at Home works with multiple partners to provide these services, including home health agencies, short-term rehabilitation providers and others. 

Goodwin House at Home currently offers five different plans that range for those who are 55 and older to those older than 90. Two plans with a co-pay structure are intended to work for those who already own their own long-term care insurance policy. Another plan is 90% refundable, similar to a CCRC entrance fee structure. The smallest plan has the lowest fees, and is well-suited for an individual only looking for minimal home care down the line. The most comprehensive plan matches that average cost of nursing home care, though there is a cap on a lifetime benefit. 

Defining a Trend

Goodwin House is not alone in providing their services in an innovative model. Offering continuing care benefits is catching on among senior housing providers, both for-profit and non-profit companies. Just a few years ago, more than one-third of CCRC operators that didn’t already operate an at-home branch were considering it. Senior living providers that have expanded services have reported higher revenue rates

“It’s definitely a trend,” Skeens said. “At most of the national conferences we are seeing more and more programs to help providers understand how to provide services in the home. Many of them are based on this model.” 

Similar models for continuing care services are popping up in different forms. The Arizona-based organization Sun Health, which operates three senior living Life Care communities, has launched a similar initiative aimed at seniors who want to age in place: Sun Health at Home. The initiative is not a home health agency itself, but will provide coordinated care services by pairing older adults with a wellness coordinator who connects members to medical and non-medical service providers.

Unlike Goodwin’s long-term care insurance model, Sun Health’s model includes a one-time membership fee and a monthly fee based on age and the plan selected that is an alternative plan to traditional insurance. 

“We are excited about this program because it will help people stay connected and active,” Jennifer Drago, Sun Health’s executive vice president of population health, said in a statement. “It will also reduce the likelihood that they will have to move into a long-term care facility.” 

As more operators understand that seniors may want to remain in their homes during retirement, it is likely more of these types of care models and service lines will continue expanding.  

Written by Amy Baxter

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