Juniper Slashes Hospitalization Rates by Integrating Senior Housing, Care

This coverage of the 2017 National Investment Center for Seniors Housing & Care Spring Investment Forum is brought to you by Mainstreet. As the nation’s largest developer of transitional care properties, Mainstreet specializes in real estate development, value investments and health care. With Mainstreet’s support, SHN is bringing live event coverage of the NIC conference, which draws developers, providers and operators within the post-acute and preventative health care services space.

A program developed by Juniper Communities has achieved striking results, suggesting that senior housing providers can help drastically lower costs to the Medicare program while enhancing quality of life for older adults.

High-acuity residents at Juniper have 50% lower inpatient hospitalization rates and more than 80% lower readmission rates than a similar population of non-Juniper Medicare beneficiaries, according to findings released Wednesday at the National Investment Center for Seniors Housing & Care (NIC) Spring Investment Forum in San Diego. Juniper credits its Connect4Life model, which integrates health care and hospitality services in a variety of ways.

Source: “Integrated Care in Seniors Housing that Meets the Triple Aim”

Based in Bloomfield, New Jersey, Juniper provides independent living, assisted living, skilled nursing, memory care, and short-term rehabilitation at communities in New Jersey, Pennsylvania, Florida, and Colorado. The company began developing the Connect4Life model about five years ago in response to business imperatives, CEO Lynne Katzmann (pictured above) said in announcing the study results at the NIC conference.

Specifically, increasing acuity in the resident population was leading to lower length of stay, while more competition put further pressure on census.

“We went about our Connect4Life program not because we believed in collaboration and breaking down the silos, but for a simple business reason,” Katzmann said. “We needed to make sure we could remain profitable over the long haul. We needed to establish market share so we could keep our occupancy high.”


To achieve these objectives, the Juniper team decided to provide more integrated on-site health care to complement the more hospitality-driven aspects of senior housing, on the basis that this would help frail elders age in place for longer periods of time and also differentiate the company from its competitors. The resulting Connect4Life platform is based on three key components.

One is co-located services such as therapy, pharmacy, labs, and primary care. The primary care—provided by Redwood Health Partners—is especially important, as it is the “glue” that connects the internal providers with external ones, Katzmann said.

Another component is a “high tech” aspect that utilizes a shared platform, in this case the PointClickCare EHR, to transfer clinical information and enable communication. Juniper requires the co-located providers to all be on the same tech platform as a “non-negotiable” aspect of their partnership.

The third component is the presence of human navigators, whom Juniper dubbed medical concierges or “emcees.” Like the emcee of an event, these workers orchestrate the integrated services and communicate with all the stakeholders, including residents’ families.

Other providers also are bridging health care and hospitality to varying degrees, but the “secret sauce” for Connect4Life is having this total high-tech, high-touch package, Katzmann said.

Wide Implications

The program already has earned plaudits for Juniper and helped the company achieve its goals; its average length of stay in senior housing was 1.4 months longer than the national industry average as of about a year and a half ago, Katzmann told SHN.

More recently, Juniper engaged a third party, Anne Tumlinson Innovations LLC, to compare resident outcomes against the Medicare population as a whole. The sample included 471 Juniper residents across 10 assisted living communities; based on data collected through assessments, level of care determinations, and EHR records, this group was compared against more than 6.2 million comparable Medicare beneficiaries living in the community.

Not only did the Juniper residents have much lower hospitalization and re-hospitalization rates, they also utilized fewer services than a similarly frail Medicare population living in senior housing, and the Juniper group had 15% lower emergency department use.

It is the Connect4Life platform that is the primary differentiator, Katzmann believes, while not discounting that factors such as staff retention play a role.

The findings are significant not only because they validate that Connect4Life is a successful business model that other private-pay senior housing providers could emulate, but because they demonstrate the value of senior housing to the health care system as a whole.

“We’ve shown, I think, that seniors housing with integrated care can be a major population health management tool,” Katzmann said.

That is, the federal government, states, and major payors such as managed care organizations all are seeking to “bend the cost curve” by reducing utilization and costs related to the most expensive subsets of patients—notably frail seniors with multiple co-morbid conditions. This is the very population served by Connect4Life.

Source: “Integrated Care in Seniors Housing that Meets the Triple Aim”

As such, the model demonstrates the “integrated approaches” theme of the NIC conference, focused on how connecting senior housing with health care and supportive services can create tremendous value for the businesses involved as well as the health care system writ large.

“New partnerships taking root between traditional seniors housing and care organizations on the one hand and health and supportive services organizations on the other hand are breaking down traditional silos between real estate and non-real estate-based providers to better support high-quality, modern, and comprehensive care for America’s frail seniors,” Bob Kramer, CEO of NIC, stated in a press release issued Wednesday.

Written by Tim Mullaney

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