This article is sponsored by MatrixCare. In this Voices interview, Senior Housing News sits down with MatrixCare EVP Gary Pederson to learn why keeping senior living residents in the lowest setting of care matters more now than before the COVID-19 pandemic, how the senior living industry stands to benefit as Centers for Medicare & Medicaid Services (CMS) shift toward reimbursing for wellness efforts and how a virtual Route 66 race in senior living built community and better health.
Senior Housing News: What are the career stops that you’ve had that most inform how you work today?
Gary Pederson: I’ve been in health care technology for 25 years. I started with Cerner Corporation, the leading acute electronic health records provider in the world. When I began there in 1996, I had a front-row seat to witnessing and participating in moving a paper-based acute care model to electronic. Post-acute has been a bit of a laggard in that regard.
My last position at Cerner was the most relevant to my career here at MatrixCare. I ran an early version of our population health division, where we were envisioning many of the predict-and-prevent scenarios that exist today. Taking those population health lessons and being able to apply them at MatrixCare across the senior care continuum is probably the most relevant experience from my past.
The industry has been talking for a few years now about the importance of keeping residents in the lowest possible setting of care. Why specifically does that matter in 2021, in ways that maybe weren’t as urgent two years ago?
Pederson: Projections from the U.S. Census Bureau point to 2030 as a milestone year, when we’ll see seniors outnumbering children for the first time in history. The Census Bureau also estimates that by that same year, one in every five Americans will be over the age of 65. With this major demographic shift, we have to be mindful of the cost of care and expectations tied to paying for it. As costs increase and more people tap into federally funded health care programs, resources will decrease. That’s the reality. But if we can keep residents in the lowest possible care setting, the cost savings will be monumental.
In my four-and-a-half years on the senior living side of health care, one of my biggest frustrations is that conversations often revolve around how we, as an industry, can stop bad things from happening after a hospital discharge. If we could apply even a fraction of the time and talent toward the “health” side of health care and look at ways to keep people out of the hospital, I’m convinced we can bend this cost curve and avoid the drastic measures needed to keep Medicare solvent.
Another reason keeping residents in the lowest acuity setting possible is important has to do with workforce challenges. There are models out there suggesting that in 10 years we will not be able to support our industry with the number of caregivers we have today. If we could reduce or eliminate falls, for example, not only could we save Medicare billions of dollars a year, we could also significantly reduce the need for caregivers to take care of those seniors who have fallen. It’s both a cost and workforce opportunity.
The third reason this topic is significant is that we have the capability of making a difference. We have technology available today that provides remote patient monitoring and the ability to create rules and alerts to notify family members, caregivers or neighbors when an adverse event is likely to occur. Deploying this technology today will help us achieve fewer falls and better health, and move toward this critical goal of keeping our residents in the lowest possible care setting.
What is the most important way operators can employ wellness and prevention to keep residents in that lowest possible care setting?
Pederson: Technologies exist today at MatrixCare that our customers are using to help with resident wellness and prevention. One of those technologies is a fall prevention solution that was developed using deep machine learning algorithms based on an analysis of thousands of data points. This solution was built to help our providers make better decisions about how they manage residents and their potential for unnecessary falls. We also use some of those same technologies to do things such as tracking progress of a fitness plan, for example. But for this concept of preventive health to really take shape, it needs to begin with the payers.
We’re still operating under this CMS reimbursement scenario where if someone has an unnecessary fall, they go to the emergency room for treatment, may spend a few days in the hospital, and Medicare pays for that. But the fact that we’re not seeing federal financial support for the preventive side of health care is, I think, the biggest obstacle we face in giving our operators the tools they need to help keep their residents out of higher acuity care settings.
When preventive health reimbursement kicks in — and we’re already seeing signs that CMS may approve some new CPT codes around chronic conditions management — the senior housing industry is going to be in the best position to quickly scale these programs up. There are a number of wellness proof points we’re seeing in the industry that, I think, will motivate CMS to continue to recognize the importance of technologically enabling these chronic condition care plans. When that happens, more attention will be paid to how to keep people in the lowest possible care setting.
What technologies do you see being used to facilitate a small transition between care settings?
Pederson: Transitions between care settings are something we think about every day at MatrixCare. We continue to evaluate the need to develop a single resident record that flows between all care settings.
We’re continuing to focus on helping facilitate the efficient, safe and accurate flow of patient and resident data across care settings of non-MatrixCare solutions as well. The need for interoperability and insight into referral patterns from acute or ambulatory care is very important to our customers as they need to quickly make those referral decisions. Having a solution that simplifies care transitions reduces intake time, and improves resident and provider satisfaction.
You mentioned a single resident record. What is the top value of that?
Pederson: When I think of a single resident record, I immediately think of our life plan community, or CCRC, customers. They almost always require a single resident record to run a safe, accurate, financially sound business. In a CCRC, those residents move within the community. That’s their model: to allow those transitions to happen.
Ideally, these residents are spending most of their time in their independent living areas, but when they don’t, it’s fundamental that their longitudinal record follows them wherever they go. With MatrixCare, during a transition of care within the CCRC, there basically is no transition at all. It’s the exact same system.
How is MatrixCare helping residents engage with others outside of their communities during the pandemic?
Pederson: There are some great social engagement solutions out there for our industry. As you might imagine though, we’re developing and continue to invest in our own innovative solutions that lean toward the health and clinical side of engagement. Our product is called CareCommunity, and it brings an opportunity for a provider to set up personal wellness records for their residents.
This is a record that sits outside of the EHR, and doesn’t necessarily assume someone has been sick. It’s a record more focused on health and wellness. Think about this record helping manage care plans around chronic condition management, all the way to tracking general nutrition, health and fitness programs that a resident might want to monitor.
This wellness record can be fed from wireless devices. Over the course of daily living, a resident’s going to step on a scale a couple of times a week. Why not have those weights feed into their personal wellness record? A lot of seniors today wear a Fitbit, so why not have those steps automatically tracked there as well? We had this solution in motion pre-COVID, but since the onset of COVID, it has inspired us to invest even more in innovations like these and focus on preventive health.
How strong of a sales pitch do you need to convince independent living operators to participate in this? Are they enthusiastic? Are they reluctant?
Pederson: Many of our operators are so focused on taking care of residents and managing increasingly thin margins that the amount of time they have to look into programs like this is often limited. But when we have a high-level conversation about CareCommunity, their interest is piqued.
We recently piloted a fitness program where six LPC/CCRC communities recruited 10 residents each to compete and see which team could go the furthest along a virtual Route 66, over 90 days. Each participating resident received a wearable fitness tracker and connected the device with their personal wellness record in CareCommunity. We published team results every week, and the stories that came back from that were amazing.
We were really interested in how willing and able residents were to set up their personal wellness record, use the wireless fitness device and engage in preventive care measures. What we found was that this program built a sense of community — we even saw non-participants getting up in the morning to cheer on the team as they took off on their walks every morning.
Of course, there was also a newfound sense of competition. Checking every week to see where your team was along this virtual Route 66 got the competitive juices flowing. And again, going back to this mission of health and wellness, vitality and creating a sense of community for such a small experiment, we think it was meaningful and so we continue to innovate in that area.
There was a lot of gloom in 2020. What makes you hopeful for senior housing in 2021?
Pederson: Nearly every night for the last year, you could turn on the evening news, read the local paper and witness the heroic, selfless efforts of our senior caregivers to take care of our nation’s most vulnerable. There’s never been a time where such compassion for our seniors has been a constant headline.
That exposure is already impacting things that are going to matter. The COVID stimulus programs are starting to pay attention to senior providers. That’s tremendous news, and I’m not sure it would have happened had it not been for COVID. There is, I’d say, a new spirit of camaraderie in the technology sector, and in senior living as well. That is the silver lining from 2020 that will help us prepare for the changing demographics ahead.
Editor’s note: This interview has been edited for length and clarity.
MatrixCare is the only EHR provider in the industry to focus on the entire senior care continuum, dedicated to helping providers improve operational efficiencies and provide exceptional care. To learn more about how MatrixCare can help your organization implement its continuous improvement goals, visit MatrixCare.com.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more — shaping their industry in a question-and-answer format. For more information on Voices, please contact firstname.lastname@example.org.