How a Former UnitedHealth/Optum Leader Aims to Transform Senior Care with Lifespark

Lifespark recently announced the hire of Matt Nyquist, a former leader with UnitedHealth Group’s Optum arm, as chief population health officer. Nyquist will help lead Lifespark’s expansion to states beyond its home base of Minnesota later this year.

Lifespark’s growth will mark another milestone in senior living’s evolution toward being more integrated within population health payment models. And I see Nyquist’s hire as a win for Lifespark, with implications that senior living providers should unpack.

Recall that last year, Lifespark acquired the Tealwood portfolio, adding senior living to its continuum of home- and community-based care. The company’s model is to provide more person-centered, seamless care and services as people age by integrating its full-continuum services with insurance products in at-risk models, supported by a technological backbone.

But don’t expect Lifespark to go on an acquisition spree, buying other senior living operators. To achieve scale, the organization is seeking senior living partners who want to join their Lifespark COMPLETE program, Nyquist told me in a recent conversation.

In this week’s exclusive, members-only SHN+ Update, I share insights from that conversation and offer analysis of his hire and Lifespark’s plans, including:

• Why landing Nyquist is a win for Lifespark
• How Lifespark stacks up against mega-insurers such as UnitedHealth and Humana in efforts to transform senior care
• Information on how Lifespark plans to scale up

Tapping UnitedHealth and Life Time Living know-how

I found Lifespark’s acquisition of Tealwood very interesting and promising last year, as a bid to create a senior living model that meets the moment — for example, by making senior living a less fragmented part of the care continuum and leveraging Medicare Advantage plans and other insurance products to drive affordability for consumers.

But I did harbor doubts about how scalable Lifespark’s model would be. From its founding in 2004, the Twin Cities-based company grew systematically within its core Minnesota market, establishing relationships with health systems and payers and building out its continuum of primary care, home care, skilled home health, hospice and senior living. Replicating this process in other markets at a more rapid pace struck me as a daunting challenge.

Nyquist’s hire gives me more confidence that Lifespark could succeed, because the company now has someone on board who has significant experience with one of the nation’s largest insurance and health care delivery companies: UnitedHealth/Optum.

Nyquist wore several hats at Optum. As Chief Product Officer/Chief Information Officer, he was in charge of “scaling products, and modernizing and digitizing them,” he told me. That included combining digital health visits with in-person physician visits. And as Chief Information Officer – Population Health, he oversaw the technology division of a $2 billion population health business.

Prior to his time at Optum, Nyquist led the health business of Life Time Fitness, in charge of creating products like corporate wellness programs that blended a more medical element with the company’s health and fitness offerings.

This Life Time experience put him front-and-center at a consumer-oriented company that reflects several key trends in senior living, including the creation of appealing wellness programs that dovetail with people’s desired lifestyles. Consider the Life Time Living model, which offers luxury residences integrated with Life Time athletic clubs and a variety of other wellness-focused, resort-style amenities. The webpage is reminiscent of a high-end senior living company’s, touting “fresh, health” dining, concierge services and “connected living” via in-unit tech.

So, Nyquist brings knowledge of value-based insurance products at the largest scale, as well as the technology to support the goals of insurers and consumers. At least on paper, he seems an ideal candidate to lead Lifespark’s growth efforts. Whether he will thrive in a smaller, more entrepreneurial company remains to be seen, but the opportunity to build something is part of what drew him to Lifespark.

“I wanted … to join a company that had a great mission and a great culture, and had the opportunity to do something without some of the limitations that exist within a large company,” he said. “And Lifespark is really uniquely positioned to provide disruption by starting centered around the member and where they live, and managing that longitudinal relationship.”

Lifespark’s advantages

As that last quote suggests, Nyquist sees a need for senior care disruption and transformation.

“The way we serve seniors is going to have to change,” he said, citing baby boomers’ expectations to be served in a more tech-enabled and consumer-centric way, with more services provided in their homes.

And he sees health systems and payment models already being forced to adapt, including through the expansion of global risk models in which providers and payers are responsible for outcomes.

Certainly, these trends are reflected in the strategies of the largest U.S. insurance companies, which are taking steps to acquire providers across the continuum and drive a more integrated, outcome-based experience for consumers, rooted in value-based payment models.

Part of this strategy involves acquiring or building out home care and primary care capabilities. Earlier this year, Nyquist’s former employer UnitedHealth/Optum acquired home health giant LHC Group, while Humana (NYSE: HUM) led this charge with its acquisition of Kindred at Home. 

On the primary care front, this week brought a flurry of news. CVS — parent company of Aetna — was reportedly considering an acquisition of One Medical. Just today, news broke that Humana (NYSE: HUM) is interested in acquiring Cano Health. Both One Medical and Cano are part of the new generation of primary care provider, featuring concierge-style service, more sophisticated technology and value-based insurance plans.

These moves are designed to solve arguably the biggest impediment to more integrated and value-base care, which is the fragmentation of service delivery across the health care system.

“I think everyone recognizes that longitudinal care is important, the challenge in doing it is the system tends to create a lot of breaks,” Nyquist told me. “So if you need RPM [remote patient monitoring] done, you have a company that comes in and does that. If you need palliation or end of life services, someone comes in and does that, as the first time you’re meeting.”

He believes Lifespark is “really ahead” in already having all these different pieces of the continuum in place, to be able to avoid the disruptions caused by the entrance of different teams and different technologies at various stages of the aging process.

Essentially, Lifespark began by creating a continuum of care and overlaid insurance products, whereas the large insurers are working in the other direction and now trying to acquire providers and build out a continuum that they will be able to exert control over.

Certainly, insurers have the resources to rapidly transform into full-fledged “payviders,” and in fact, they are already doing so. But Nyquist seems skeptical of how smoothly and successfully these efforts will go.

He repeatedly emphasized that a key differentiator for Lifespark is the company’s culture and “compassion” toward older adults, and a holistic approach to whole-person care. 

I believe he’s getting at one of the biggest sticking points in the shift to volume over value in how health care is delivered in the United States. The patient’s needs and goals — and the quality of the consumer experience — can take a backseat to the goal of lowering costs and driving efficiency. It’s a point raised earlier this year by SCAN CEO Sachin Jain, in a Forbes column.

When I spoke with him, Nyquist did not call out his former employer — or any large insurance company — by name. But anyone who has dealt with the bureaucracy of a giant insurance company understands why they are not famous for putting the patient/consumer first.

Some of the companies that insurers are acquiring, such as the concierge primary care providers, have made an effort to be more consumer-centric. But making an acquisition is not going to change the culture of an organization the size of UnitedHealth, and Nyquist thinks that a smaller, nimbler company like Lifespark can move more quickly to disrupt senior care as we know it. 

Lifespark’s growth strategy

Nyquist was tight-lipped about specifics but did offer some insights into how Lifespark will pursue scale in the coming months.

The company has a “pretty aggressive plan,” with five states/geographies targeted first. Talks are ongoing with potential partners in those areas.

Nyquist is focused on putting in place the necessary processes and the quality control apparatus needed to gain scale. And unsurprisingly, given the premium he places on Lifespark’s culture, perpetuating that culture is a key goal.

“So, finding the right types of people hiring up and training them — we have a training university that we put together, which really trains on geriatric expertise,” he said. “We’ve built a lot of the the foundation, the didactic courses, the curriculums to make sure that we’re really treating seniors the way that they need to be treated … and deploying that curriculum across everyone to make sure that our members get treated the way that they should, I think is a key component.”

Lifespark has a “very clear value proposition” for potential senior living partners, based on showing what a “complete health care model” has achieved already in Minnesota, he said.

It remains to be seen how well the Lifespark COMPLETE model will translate in new markets, as they bring senior living partners aboard who have their own operational approaches and cultures; in Minnesota, Lifespark Senior Living has been putting in place specific practices under the leadership of Bill Thomas, who spoke about the wellness-focused elements of the model at our recent WELLNESS/DISHED event.

Another issue comes down to payment; this was the pointed question that Juniper Communities CEO Lynne Katzmann asked Thomas at the event — how much of a financial reward will senior living providers get for helping to achieve cost savings and other goals within the Lifespark model? Naturally, Lifespark leaders say that senior living partners will be compensated fairly for the risk they take on, but the proof will be in the contracts.

And then there is the issue of technology integration with new partners in senior living and other parts of the care continuum. Lifespark is creating a tech platform that draws on data from various sources to create a more holistic picture of older adults, to support more proactive wellness efforts and targeted health care interventions. New partners will not be required to adopt any particular electronic health record, but the Lifespark system will pull data from their EHRs and other sources and “where appropriate” push information back into those providers’ workflows, Nyquist said. 

Lifespark’s growth will expand the options that operators have for becoming involved in population health models. Of course, working with Lifespark will not make sense for every senior living provider, and operators have various other options to weigh — including starting their own Medicare Advantage plans like the Perennial Consortium, or working with established insurance companies that are rolling out more MA special needs plans tailored to senior living. 

But Nyquist joins the growing chorus of voices heralding that a new world of value-based care has arrived, and senior living providers must develop and execute a strategy for becoming more integrated in the health care system and tapping into new payment streams.