10 Senior Living Providers Collaborate on New Medicare Advantage Plan

Ten senior housing and care providers in the Twin Cities area of Minnesota will be offering a new Medicare Advantage special needs plan to their residents next year.

The plan is a collaboration between the 10 senior living companies, Minneapolis-based nonprofit health plan Medica and integrated care provider Genevive.

The senior living providers together have 78 communities, representing about 5,500 eligible beneficiaries, according to an announcement released Wednesday. Genevive and Medica believe that this is one of the largest rollouts of a special needs plan in the nation.

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The plan will be available exclusively to residents of the following organizations: Benedictine Health System; Cassia; Catholic Eldercare; Episcopal Homes of Minnesota; Goodman Group; North Cities Health Care; Presbyterian Homes & Services; Saint Therese; Volunteers of America; and Walker Methodist.

The plan will be available with a Jan. 1, 2020 effective date, and include coverage for prescription drugs, transportation, dental services, vision and hearing care, as well as hospital services with Medica-participating providers contingent on clinical considerations.

Genevive — co-owned by Presbyterian Homes & Services and Allina Health — will provide holistic care to plan members, through an interdisciplinary team of physicians, nurse practitioners, care coordinators and others.

This is just the latest example of the increasing role of Medicare Advantage within senior living. With MA insurers being given more freedom to cover services that are commonly offered in assisted living and other care settings, Medicare Advantage is emerging as a payer within communities that previously were entirely or almost entirely private pay.

Some large providers such as Erickson Living and Sunrise Senior Living offer their own plans, while some smaller providers have teamed up to start plans. However, launching a plan is a complex and financially risky proposition, and some senior living providers have been looking for other ways to play in the Medicare Advantage space.

The Medica announcement comes about a week after real estate investment trust Welltower (NYSE: WELL) announced a collaboration with Anthem affiliate CareMore, to bring more integrated services into senior living communities via a Medicare Advantage reimbursement model.

Facilitating residents’ enrollment in Medicare Advantage could lead to benefits for senior living providers, notably increased length of stay. That’s because by enabling access to more immediate care services and coordination via entities like CareMore and Genevive, MA plans could help residents stay well longer, while also reducing their out of pocket medical expenses. The affordability factor is one driving consideration behind the effort in the Twin Cities.

“By taking financial accountability through this value-based contract with Medica and Genevive, senior care providers can expand wellness and other supportive services for a growing number of older adults, many of whom cannot afford the services and supports that lead to better living and have been proven to reduce the rate of unwanted invasive medical care,” Presbyterian Homes & Services President Dan Lindh said in Wednesday’s news release.

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