HumanGood CEO John Cochrane sees the coming years as the most pivotal time for senior living providers to improve the healthspan of older adults through innovation.
Cochrane frames improving healthspan, the number of good years older adults experience as they age, as the central challenge for the senior living industry. HumanGood is approaching this challenge by partnering with aging research groups to better study the biology of aging, while also focusing on understanding new customer needs and what they aspire to achieve in their retirement years.
HumanGood recently partnered with the the Buck Institute for Research and Aging to study older adults living at HumanGood communities through research on aging, chronic illness and the mechanisms that drive decline or resilience in aging. Programming at HumanGood communities targeting strength, balance and stability, alongside brain training modules, have helped put these research-based goals into practice.
“Imagine what that means for the population we serve if we can have that kind of impact in that kind of short period of time. Imagine what we might be able to do to improve the aging experience for the people who live with us and the people who are even outside our walls,” Cochrane said during the most recent SHN Transform podcast.
As part of the Perennial Consortium, a Medicare Advantage network including multiple senior living providers and risk management partners, HumanGood is focused on finding ways to fund nontraditional interventions that most impact healthspan.
This pursuit of improving healthspan comes as the industry enters its “platinum age,” following the long-awaited arrival of the baby boomer demographic in senior living. These new customers are causing a fundamental shift in expectations around aging as older adults today expect to live over two decades past retirement age. Older adults today don’t want to manage decline, but maximize their opportunities, seeking out tools, environments and support that help them live with purpose, vitality, health and connection, Cochrane said.
In this fundamental shift, Cochrane sees an opportunity for senior living providers today to move past traditional institutional, deficit-based models to help older adults age with energy, ambition and agency for the foreseeable future.
“If we play our cards right, we’re going to be living it for the next 20 years,” Cochrane said during the podcast.
Editor’s Note: The following transcript has been edited for length and clarity
On HumanGood’s recent operations and momentum:
As we were talking just before we started this interview, you used the word energy, and I think that’s such a perfect descriptor for what we see going on in this field today. It’s not just energy among the providers, folks like HumanGood, or folks like you who are in the industry from a different angle. It’s energy from our customers, and that’s really exciting for me. We have a lot to talk about in terms of the evolution of our field, the evolution of the customer, the evolution of expectations, and the opportunities that come with that. Like a lot of providers, we’re starting from a really strong base, and we come into this new world with a really significant competitive advantage that we need to highlight for the field.
I’ll give you a few highlights and metrics as I look back over the past couple of years for HumanGood. This will sound like I’m bragging, which I’m only partially doing, but what I’m really trying to do is set up the fact that we have a really strong base for moving into this new field, and I think it is a new field in many respects. When I look at HumanGood, how we’re positioned, and what our resources and restraints are, the very first thing I look at is team member engagement. In the past year, we got responses from more than 88% of our team members, and we have an engagement score of 85. If you look at engagement scores for employees globally, around 25% to 26% of people are engaged. We do a little better in the U.S., around 36%. To get an 85 engagement score speaks really well, I hope not just to HumanGood, but to our field and to the type of people we attract who have a real passion for the work they do. That positions us so well, both as a company and as a field, to meet the needs of the evolving consumer.
The reason I highlight that first is, for me, success starts with our team members. If we can’t attract, reward, retain, and engage the very best people, if we can’t find those passion-minded people, we don’t have a hope of actually delivering on our promises to the field. Engagement is the very first thing I look for in our company and in others. In looking at success, the second number I look at is our Net Promoter Score, and that’s just our core evaluation of customer satisfaction. I’m proud to say that we have a 72 Net Promoter Score. If you’re familiar with how Net Promoter Scores work, they run from a minus 100 scale to a positive 100 scale. Getting to a 72 in a field like ours that is 24 hours a day, 365 days a year is really significant. We’ve gotten there because we’ve really leaned into partnerships, collaboration, and engagement with our customers, our residents, and our families. That has not only produced a higher NPS, but what it’s really produced is the sense of we’re in this together, creating something important together. When you combine that NPS with the engagement score, you really start to see some magic happen, and that’s what we’re looking for.
Similarly, on the quality side, that is really important for us. We provide care in assisted living, skilled nursing settings, and memory support settings, so evaluating the quality of that care is important. I’m proud to say that our CMS star rating puts us in the top three of multi-site providers across the country. Again, holding all of those things in balance is really important.
On senior living’s role improving healthspan:
If the accomplishment of the 20th century was adding years to lifespan, I think the biggest challenge for the 21st century is going to be adding years to healthspan, because what we’ve discovered is there is an enormous, surprisingly growing gap between lifespan and healthspan. We had this tremendous success adding years. How do we add more good years for more people? That is really what’s driving us at HumanGood. When I look at how we’re trying to do that over the past couple of years, we formed partnerships with folks like the Buck Institute, the world’s leading research organization understanding the biology of aging, so we can understand the science of aging. We’ve run pilots with our residents to determine how many of these chronic conditions people are living with can be managed, how many can be reversed, and how many of the fears people have as they age can be dealt with in a really positive way. It’s interesting if you poll seniors about their two biggest fears as they age: number one, no surprise, is fear of falls; number two is fear of cognitive decline or dementia.
So we’ve run programs with our residents to say, if falls is the biggest fear people have, how can we improve people’s strength, balance, and stability? Andrew Smith, who leads our innovation efforts at HumanGood, put together a series of pilot programs to assess whether we can actually improve people’s strength, balance, and stability in a measurable, scientifically validated way. We took a cohort of residents, put them through a series of assessments that included a sit-to-stand test, a grip strength test, and a single leg balance test, and then we put them into a 12-week program to say, hey, can we move the needle on these metrics? Can we actually improve the aging experience for people? What came out of that was actually just kind of shocking. Everybody improved on every single metric. In just 12 weeks, we moved the needle on every single metric that mattered to strength, balance, and stability. Single leg balance in 12 weeks went up by a score of 177 percent. Imagine what that means for the population we serve if we can have that kind of impact in that kind of short period of time. Imagine what we might be able to do to improve the aging experience for the people who live with us and the people who are even outside our walls.
On staffing priorities for HumanGood:
Understanding where we’ve come from is critically important to understanding how to position ourselves for the future. I would say, from a staffing perspective, it’s interesting. Five years ago, you were right: we were in this black swan event. Staffing was challenged, the whole world was challenged on so many different fronts, and we were dealing with all kinds of issues related to staffing along with everything else. Staffing is one of the issues I actually don’t worry about at all at this point. In terms of actually getting people in the door, we have no challenge with that whatsoever, and we’re seeing really high-quality people coming in.
Where we’re placing our priorities is really on what you highlighted in your comments. It’s on staff development, helping people understand that whatever door you come through to get into HumanGood, there are many more doors that can open up for you, and our job is to help you succeed where you are today and grow into where you want to be tomorrow. That’s really what we’re investing in, and we have multiple paths to do that.
It starts with bringing people in and enrolling them in a program we call HumanGood U, which can include everything from internal development programs and internal coaching to Good to Grow programs, which are internal leadership development programs for people who are new to leadership as well as people who are very experienced in leadership. Giving people a chance to upskill constantly from where they are, we give people the opportunity to get a college degree on the company if they don’t already have one. We’ve supported people getting advanced degrees in many cases, and we support people getting CNA certifications all the way through to getting their RN degrees. We have multiple paths to help people get knowledge and then translate that knowledge into career opportunities within HumanGood across the various divisions that we operate. We see people move from affordable housing development to community operations or other areas, and we’re really proud of those efforts.
Having said that, we also think it’s important to continually refresh ourselves by bringing people in from the outside. One of our mantras is that about 20% of our hires should be people coming from outside the industry because they bring in fresh energy, fresh perspectives, fresh points of view, and fresh challenges. We think that keeps us on our toes, keeps us sharp, and helps us better meet the needs of a very different consumer, someone who is looking for something different than in the past. That requires continual reinvestment in your team members. When I talked about our team member engagement scores at the top of this call, that investment has really paid off for us. People understand that if they lean into us, we will lean into them. That has been a mantra of ours for a long time, and it’s real, and people know it’s real. We have multiple stories of people entering the company at one level and, over a relatively short period of years, moving into significantly different responsibilities. It’s not easy to set up those systems, and it’s not inexpensive to set up those systems, but it’s a lot more expensive to not have an engaged and stable workforce.
On reaching senior living’s ‘platinum age’:
It may not even be a golden age; it may be a platinum age of aging. Not only is it possible, I would say the difference when we first talked and now is that we’re living it. We’re in the middle of it. This is the golden age of senior living. When you look at what is scientifically possible, what is changing in the consumer, and what we can actually execute and deliver on, the golden age is here. If we play our cards right, we’re going to be living it for the next 20 years.
It’s not just demographic growth. I think people get focused on that. The growth in the number of people over the age of 65 is exciting, and that market is clearly exploding globally. But that’s not even the most exciting dynamic. The most exciting dynamic is the shift in the consumer profile, the shift in expectations around aging. We’re moving from this idea of care and managing decline to one of managing opportunity. This is the first generation of older Americans who expect to live to be 90. Before, we had what I think of as accidental aging: you lived to be 90, but you couldn’t believe you’d lived that long. People now routinely expect to live that long. If you’re 60 or 65, you’re looking ahead and thinking, “I’ve got another 20 or 25 years in front of me. I’m not worried about managing my decline. I’m thinking about how to make the most of those years. What tools, resources, and interventions can I apply to my life?” How people define that will be different, but that’s the opportunity.
When I think about this golden age of senior living, I don’t mean just residential living. I mean embracing this third half of life and moving from decline and limitation to purpose, vitality, connection, health, and vibrance. That shift is real, and we’re seeing it right now. For those of us who have been in this world for a few decades, as I often say, I am more excited and optimistic about the next 10 years than I have been about the last 15. As much as I’ve enjoyed my career, I am blown away by what’s coming. I don’t think we can exaggerate what is possible for our field. We have an enormous competitive advantage in helping the consumer navigate this shift. We have people who live with us. They know us and trust us, and many of our companies and individuals have decades of experience understanding the consumer. Put that together, and this is beyond the golden age. It’s the best we could imagine for ourselves, our companies, and most importantly, the people we serve. So yes, I absolutely stand behind that earlier quotation, and I would amplify it 10 times.
On changing the perception of senior living:
The public perception of senior housing in our field is antiquated, and in many cases it’s antiquated because we still have operators providing antiquated properties and programs, serving yesterday’s customers. To the extent that we have a bit of an image problem, and I think we do, I think you get over that relatively quickly and easily by showing people what is really possible and delivering on what is possible in a measurable, sustainable way. When you do that, I think you get over this image that we carry as a field relatively quickly.
The problem is we still have a field where some organizations understand this shift, executing and delivering programs that really allow people to grow, thrive, and improve as they age, meeting them where they are and where they want to be. On the other hand, we still have some operators who are providing services as they did 20 years ago. I think we’re increasingly seeing that you’re not going to be successful in tomorrow’s playbook running yesterday’s plays. We will move past this as consumers start to realize this is the place to go to age with vitality, purpose, and health. When we do that successfully, the image problem will be solved.
On future growth of HumanGood and outlook:
I think growth will continue to come. We’re in a field that’s still consolidating. It needs to consolidate. We need scale. We need resources. We need talent. We need all the attributes that come with a certain level of scale, and we’ve seen the real benefits of that at HumanGood as we’ve grown through the years. So we will continue to grow by acquisition and affiliation. You’ll see our footprint get larger. You’ll see our unit count grow. You’ll see our team member count grow for all the right reasons. We’ll grow in the right way for the right reasons.
The more exciting growth you alluded to is that we currently serve a fairly small part of the population on the upper income stream with life plan communities, and we serve a fairly small sector of the population in affordable housing. In the middle, you have this large gap: the forgotten middle, as NIC refers to it. They’re not forgotten by us, and I don’t think they’re really forgotten today by the industry as a whole. What we’ve struggled to do is find a way to translate what we do so well on both of those extremes and meet the needs of people in the middle.
As I think about growth and how we close the gap between healthspan and lifespan, delivering more good years to more people in a measurable, sustainable way, we’re going to start with the people who live with us. Those are the easiest places to run pilots, understand the consumer, and identify the interventions that matter. But for me, Austin, the exciting growth is going to come when we can take those same breakthroughs and apply them to people who live outside our walls. When I look again at the challenge of the 21st century, closing this gap between healthspan and lifespan really is the trillion-dollar opportunity and moral need that we have as a country. We see our real growth opportunity coming in closing that gap at scale and putting together the operating system that will allow us to do that. So again, we will probably increase our footprint, grow our unit counts, and continue to grow our traditional business for a lot of different reasons. But we’re also going to look to grow outside our walls, and for me, that is going to be some of the most exciting work that we do as a company and as a field.
On innovation and the need to be willing to fail:
Job number one is we’ve got to continue operating what we have successfully, and that’s a message we carry through the company consistently: long-term success starts with today’s success. I highlighted at the top of this call some of the metrics we’re proud of as a company, and we’ve worked really hard to get to those. Maintaining that performance is really the springboard for everything else we want to do. It’s necessary, but it’s not sufficient to realizing our ambition. Job number one: run the business you have, run it successfully, and pay attention to what’s in front of you. Again, I almost can’t say that loudly enough or too often.
The second priority, and I think this is hard for our field, is to really invest meaningfully in innovation and understanding the new consumer. Part of that investment is not just putting resources of both people and capital into it. That’s important, but it’s also changing our approach to how we think about operations. We’ve got to be willing to fail at some things, and we’ve got to be willing to try new things. For many of us in the field, that’s hard. We’re used to achieving success where we don’t make bets we know we can’t win. We’re going to have to be willing to invest much more significantly in innovation and in partnerships. It is an investment: it takes money, time, resources, and strategy, and that’s really where we’re going to be making some significant bets. I give enormous credit to our board for pushing us to invest even more in innovation than we were necessarily thinking. They fully understand how important it is to put the resources of the organization into innovation if we’re going to have the kind of future that we imagine, and if we’re going to have the kind of positive impact on the world that we believe we are called to have and are capable of having. As much as we need to run our current business, we often talk about having one foot in today and one foot in five years. Everybody gets the foot in today; the foot in five years is sometimes a little tougher. You have to have both, and you have to invest meaningfully in both.
Companies featured in this article:
Buck Institute for Research and Aging, HumanGood, The Perennial Consortium
