Senior Living Operators Embrace ‘Payviders’ in Building Value-Based Care Models

The needs and demands of assisted living have been dramatically changing in recent years, and operators are shifting to meet those needs.

Among the ways of doing so includes contracting with independent “payviders,” like Curana Health, to provide medical services directly to residents, which operators have begun doing to build new value-based care models within assisted living and memory care communities.

That was among the opinions expressed at a value based care panel at a recent Medicarians conference in Las Vegas, where value-based care was a main subject of discussion.


Nick Gesue, founder and CEO of Alder View Capital, said that assisted living is growing more sophisticated, with services now resembling what skilled nursing operators did 10 or 20 years ago. Although that sophistication is a challenge for operators that aren’t ready for it, it is also an opportunity for those that are.

“As states start to increase the Medicaid dollars towards assisted living, that’s going to further move the shift away from skilled nursing,” Gesue said. “But from a longer-term stay perspective, assisted living is really where most of that population would choose to move, if they could, and when they can.”

Solera Senior Living Founder and CEO Adam Kaplan also noted that assisted living is a more sophisticated business in which to operate in 2024.


“When there is a challenge with their medications, they’re looking at us, not the pharmacy. When there’s a medical need, they’re looking to us, not necessarily to their primary care doctor,” Kaplan said. “The model is evolving.”

Previously, Kaplan has noted that he believes reimbursements are in the cards for operators of assisted living and memory care communities, to help offset the cost of providing those services

Senior living operators now place a greater emphasis on mental health and depression for residents, and are also emphasizing socialization and wellness, according to Alan Fairbanks, president of the Value-Based Care Alliance at Serviam Care Network.

By adding new Medicare payment options or other value-based care models, operators can both provide the services that residents want while also not breaking their bottom line. As such, Fairbanks said there is a “tremendous opportunity” to provide more meaningful value-based care within the industry.

“Payviders” such as Curana Health, can help create new payment options, such as through Medicare Advantage, to provide funding for “an advanced level of care,” according to Curana Health Executive Vice President of Strategic Initiatives Amy Kaszak.

“It’s great to be able to directly deliver services to their home in a pretty efficient and effective way,” Kaszak said.

These kinds of providers also need to know how to engage within the community as part of the care team to “fully leverage the benefits they are providing,” Kaszak said.

Fairbanks added operators have a chance to leverage their role as “trusted advisors” to increase the level of care for residents by allowing them to see a physician or nurse practitioner at least once a month.

“For us, that was a transformational move to get in a relationship and start providing what I would consider more proactive, wellcare to our residents versus living in the sick care system that we live in today,” he said.

Shifting to a “payvider” isn’t without its challenges, including stiffer competition from other operators in the area.

But Kaplan added Solera is sticking with payviders like Curana for a multitude of reasons, including alleviating burnout for team members, helping combat margin contraction because of wage escalation and opening a new revenue stream for the communities.

“We have a lot of conviction that ultimately when we track our health outcomes in our setting that it will prove that senior living is one of the best settings of care out there,” Kaplan said. “We think we have a great foundation. But we have to build upon that in aligning with groups like Curana. So we recognize there’s no playbook and we’re going to have to keep recalibrating.”

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