Covid-19 is cementing senior living’s place on the health care continuum, as more owners, operators and health care providers join forces to keep residents safe from the virus while maintaining environments where they can thrive and achieve positive health outcomes.
In one example of what the future might hold in terms of senior living providers collaborating more closely across the health care continuum to offer services on site, San Diego-based SRG participates in a program called CareMore Touch, through a partnership between its capital partner, Welltower (NYSE: WELL) and CareMore’s parent company, Anthem (NYSE: ANTM).
And changes approved to next generation accountable care organization (ACO) models by the Centers for Medicare & Medicaid Services (CMS), which are going into effect next spring, will give more seniors the opportunity to participate in these programs without having to change health insurance plans. This has the potential to lead to better health outcomes and savings for residents and providers alike.
The benefits that SRG has seen via the CareMore partnership — and the industry’s Covid-19 response — have proven that senior living belongs in the care continuum, and the integration of health care and hospitality will become further entwined in senior living operating models in the months and years ahead, SRG Founder and CEO Michael Grust said Tuesday at the 2020 National Investment Center for Seniors Housing & Care (NIC) fall conference.
“We are at an important nexus point,” Grust said. “The ability to deliver on all of these things and be the catalyst for quality of life is truly going to make the difference with our industry going forward, because that is what’s going to compel people to leave their homes.”
The relationship between SRG and CareMore has deepened in the last year, and dovetailed with the pandemic disrupting the industry. CareMore brings a medical component to the hospitality and wellness foundation established in the SRG communities participating in the Touch program. As demand for telehealth and telemedicine, and home health services has exploded throughout the pandemic, CareMore’s teams can handle all of these, thereby limiting the number of outside visitors to a community and reducing residents’ risk of exposure to coronavirus.
“We need to limit our overexposure of healthcare practices and professionals into some of these campuses and communities, because those are the ones that are carrying this virus,” Jim Lydiard, general manager of CareMore’s Touch program, said during Tuesday’s NIC panel.
SRG residents opting to participate in CareMore Touch are given baseline health assessments called “healthy starts.” After reviewing their medical histories, residents are then placed in individualized care plans that are continuously monitored by SRG staff for any changes in condition, at which time CareMore can deploy health care workers and services to ensure residents feel safe and comfortable in their home environment, as opposed to being admitted to a hospital.
Lydiard estimates that CareMore visits are two-thirds proactive, which elevates resident level of engagement and contributes to positive health outcomes. And not all visits are to address medical issues, although SRG remains the primary provider that handles support with activities of daily living and overall resident engagement
“Maybe they just need a friend,” Lydiard said.
SRG, meanwhile, has a quality assurance program which tracks, among other metrics, hospital admission and readmission rates. The CareMore affiliation allows communities to react to a resident’s change in condition faster, and reduce the frequency and volume of hospital admissions.
Most importantly, the affiliation allows residents to have a measure of agency in their own health outcomes, because they are working through the care plans and achieving desired results.
“[The partnership] is a no-brainer,” Grust said.
The enrollment rates to CareMore Touch vary by community, in part because current CMS guidelines on ACOs require seniors to change their health insurance plans in order to participate.
“We’ve struggled, campus by campus, to build momentum,” Lydiard said.
But the momentum gains steam once residents see the outcomes of the initial enrollees. Typically, residents at SRG’s participating communities buy in on the program when it reaches around 20% enrollment. CareMore communicates with community staff and executive directors on the benefits of the program, as well as how to identify residents who may benefit from it. But the two do not actively work together to hard-sell the program to residents.
But some changes are coming, which could make it easier for the CareMore program to gain traction within senior living communities. CMS approved expanding its next generation ACO model to empower more physician groups like CareMore. This will allow SRG residents to participate without needing to change their health care plans. They can stay on traditional fee-for-service Medicare and change nothing in the way of their benefit structure or their network, in terms of preferred primary care physicians, specialists and hospitals.
“They’ll have multiple pathways in which to have more of a proactive preventive medical model that can complement [residents],” Lydiard said.
Grust sees this as a “game changer.” Seniors are resistant to change. Being able to keep their physicians and plans, while participating in CareMore, helps the due diligence process when considering the shift. And, this type of seamless delivery of on-site services adds to the attractiveness of a senior living setting versus remaining in a single-family home.
“Change is never easy for anybody in our target audience,” he said. “That is going to be a very powerful elixir for growing our relationship going forward.”
Covid-19 may serve to accelerate these changes. Bob Kramer, NIC founder and strategic advisor and president of Nexus Insights, noted during the panel that older adults have come to fear traditional health care delivery settings in recent months. And not only programs such as CareMore will bring care into senior living communities in new ways. An unprecedented surge in telehealth and telemedicine throughout the pandemic will facilitate the ability for seniors to receive care, and achieve positive health outcomes, in their homes.
“Increasingly, our seniors – particularly frail seniors – are seeking to have those health services come to where they live,” he said.