by Lynne Katzmann
I can’t remember a new year that has brought more hope for a better future than this one. That said, many of us are entering the year knowing that our runway to success is long. But the flip side to every challenge is new opportunity. Here is where we believe the opportunities lie in 2021:
The Vaccine
By end of Q1, I believe that most senior housing communities — residents and team members — will have received vaccines sufficient for all who choose to be inoculated. Given that current thinking is that 60% to 70% of the population needs to be vaccinated to establish herd immunity, and assuming we remain vigilant with screening, testing and proper infection prevention, senior housing will actually be THE place to be.
Juniper has decided to make vaccination a condition of employment. While a difficult decision, we believe it is critical to community safety and to finding our “engagement equilibrium” again. We also believe it is what residents want.
And that will put us on the road to recovery. There is much recovery needed: occupancy levels, consumer trust, reduced expenses (PPE, testing and staff), improved financial ratios … and the list goes on!
Partnerships
We often speak about the value of partnership. In 2021, partnership will be critical.
During COVID-19, we are often reminded of our collective responsibility for one another by the hashtag #weareinthistogether. There has been a good deal of collaboration among industry leaders. Partnerships happened quickly — often because they were needed to meet basic needs. While the imperative may be different, partnerships like Medicare Advantage — where payers and providers come together — will provide both services and new revenues to better support our underlying operations in 2021. These will be an important new revenue source as census slowly recovers.
In our greater communities, partnering with local small businesses for food or entertainment or engagement will also be mutually beneficial. We can provide space in exchange for higher quality, more diverse and less expensive programming. And yes, it might also bring in older adults to our communities to participate and in turn consider us as a living option for themselves — marketing and sales reach! Juniper has piloted Catalyst, a new program that engages the greater community to enhance our offerings. This will be a major shift in how we foster engagement in 2021.
NIC has been looking at collaboration across the health care industry — upstream and downstream connections — for several years. Recently, a new company led by Richard Burke, one of the co-founders of UnitedHealth Group, filed a public offering to raise money to create a coordinated package of services for seniors. Burke plans to buy into companies that provide both health and social services and or provide the data to integrate them and prove their value.
This type of “partnership” pushes us to consider partnership in different ways. In addition, several industry leaders are creating new models which layer partnership-provided services on real estate. Several of these are focused on the “forgotten middle”— those who don’t qualify for public assistance but don’t have the funds to pay for the type of services we provide today. These are new business models and in my mind are likely to be a bigger part of our industry story in 2021 and beyond.
Partnership will also be something I believe will be highlighted in the policy proposals of the new administration. In early 2021 we must advocate strongly for a clear definition of home as the place where an older adult lives; we must erase the distinction between home in the greater community or home in a congregate setting to permit us to better compete with home care.
Partnership is also fundamental to a new economic theory getting traction. Reimagining capitalism is the subject of a number of widely read books and articles by British economist Mariana Mazzucato, who has the ear of both liberals and conservatives. She calls for new partnership between the public and private sectors as she reminds us that some of the world’s greatest achievements — including the internet and the new COVID-19 vaccine — stem from government investment.
Mazzucato asks us to look at how we are defining value — what has value and the real potential to grow the economy. In a recent article she speaks about the long-term impact of the pandemic on the economy. She focuses on the fact that the pandemic has changed the way we define essential workers or those the economy simply cannot replace. Our workers, disproportionately represented by women and people of color, are now seen as essential. She also highlights the value of unpaid caregivers in the home, whether they care for older adults or children or anyone else unable to do so on their own. Will this change the way we define value? If so, what impact will it have on the work we do?
I venture to say, it will increase the value of our industry and perhaps give it some new credence in terms of its real value to society.
Product Redesign
When we think of product redesign, most of us think about real estate. The pandemic has changed some of our thinking about physical spaces, and I believe will have a long-term impact on new construction and substantial renovation. In 2021, the service product we offer will change.
At Juniper, we have long considered ourselves a health care provider. The pandemic has made more of us converts as we recognize that whether we wanted to be or not, we are considered health care providers. In 2021, I believe that we will redefine our products to focus on our ability to foster health.
The services we provide often prevent the need for more invasive and discomforting medical interventions including hospital stays. Our data will prove our value, and new focused messaging will make that case to consumers, who are hungry for health to permit them to lead the life they want. This too will be part of Juniper’s new program, Catalyst, and we will introduce it more widely in 2021.
Technology
Technology has had a real boost from the pandemic. The need to connect virtually to enable family visits or to facilitate a community tour, to drive pandemic strategy based on facts or to integrate providers has become critical to personal and professional wellbeing. In 2021, I believe we will continue to build on the foundation we have built in 2020.
For example, Juniper will continue to build the crowdsourced activities programming site Virtual Connections (www.slvitual.com). While we could go back to the old means of delivering programming, we intend to incorporate both asynchronous programming and live programming. The quality and options greatly expand the offerings we can offer residents. Moreover, it permits us a means to integrate with older adults living in our communities and, frankly, across the world.
Data is now a very viable and valuable asset. With most software vendors implementing an API platform, we have the ability to collect vast amounts of data into a single data pool. This has incredible potential value:
1) Interoperability permits service and provider integration, which saves time and, in some cases, reduces expensive services. This offers an opportunity to create a new revenue stream for those who are instrumental in assessment, planning and monitoring—like us.
2) The data can be aggregated and algorithms can be applied offering a new ability to predict outcomes and provide us with proactive game plans to maximize good health. Juniper will be doing both. The first with its MA plan Perennial Advantage and the second in conjunction with PointClickCare and Dascena as part of our pandemic battle plan.
Technology will also offer us the opportunity to streamline workflows. Second- and in some cases third-generation software is now available to the industry. These new platforms provide the opportunity to streamline work. New CRM offerings are a great example as they auto-document sales activities, permitting sales people to spend more time selling. This will be critical on the road to census recovery in 2021. Another benefit from improved software is the ability to visualize data to make decision making accessible to a broader group of stakeholders.
Disruption
My thoughts on 2021 would not be complete without a quick comment on disruption — of our industry from the outside.
The “Amazonification” of aging services continues. This month, Amazon has introduced Amazon Pharmacy, which will compete with the big institutional, nationwide pharmacies. Amazon’s hospitality-oriented features and apps are being adapted for providing older adults services with voice-first features. It is the tip of the iceberg. You can be sure the other tech giants are not far behind.
I also believe that private equity understands the size of our market and its potential for growth. My guess is they are assembling the pieces now with an eye towards an integrated product much like Mr. Burke wrote about in his IPO prospectus.
After a year of such uncertainty, it is hard to put stock in any predictions. That said, dreaming or better said, some free-flowing thinking has kept so many of us going this year.
I continue to believe we are well into an industry transition; the pandemic has likely increased its pace. Consequently, the ability to think outside the box may just be a saving grace. I have been graced with colleagues who have indulged me in discussion even as they continued to put out bonfires in their communities. I trust that the strength we have garnered together with increased flexibility and a big dose of resilience will carry us forward into a year of greater success.
Lynne Katzmann is a recognized industry leader, who in 2020 was inducted into the American Seniors Housing Association (ASHA) Senior Living Hall of Fame. She is the founder and CEO of Juniper Communities, a Bloomfield, New Jersey-based provider with a portfolio of 21 communities across New Jersey, Pennsylvania and Colorado.