In Senior Living, Is Value-Based Care Here to Stay?

During his campaign, U.S. President-elect Donald Trump vowed that if elected, he would bring about sweeping changes to the nation’s health care system. This includes, Trump has said, repealing and replacing the Affordable Care Act (ACA) — legislation that undoubtedly impacts the senior living industry in more ways than one.

With the next administration poised to take the helm, the future of value-based, patient-centered care in America is up in the air. Senior living providers, however, would still do well to continue practising it, according to a panel of senior living executives who spoke November 8 at the 2016 PointClickCare SUMMIT in Orlando, Florida, facilitated by Dave Wessinger of PointClickCare.

In value-based health care models, hospitals and doctors are paid for helping people stay healthy and for improving the health of patients who have chronic conditions in a cost-effective, evidence-based way, according to insurance giant Aetna. The ACA was meant, in part, to nudge America’s health care model away from fee-for-service and toward value-based care.

Focusing on value-based care would continue to serve senior living well in the future, whether or not the ACA is eventually repealed, Lynne Katzmann, founder and president of Bloomfield, NJ-based Juniper Communities, stressed during the panel presentation.

“Instead of treating sickness, we’re about promoting health,” Katzmann said of the senior living industry. “It’s about how to keep people well, rather than how to treat them when they’re sick.”

Senior living providers care about the health of the whole person almost by default, she noted. That’s why senior living residents, in general, tend to be the recipients of patient-centered care.

“And for us in senior living, that makes sense, doesn’t it?” Katzmann asked. Senior living, to Katzmann, is about “life enrichment” — providing residents with good nutrition, worthwhile programming, and peer-to-peer socialization in a safe, secure space.

“It makes sense that we are looking at a patient for life, a resident for life,” she said.

How to nurture the resident for life
Juniper Communities has adopted a “high-tech, high-touch” approach to providing patient-centered, value-based care to its residents, Katzmann explained. Senior living providers, she feels, can’t provide value-based care successfully without an electronic health record (EHR) — and one that can be shared across several ancillary services.

“Our team can’t make it work without an EHR, and a shared EHR,” Katzmann stressed. All of Juniper’s ancillary services utilize PointClickCare, she noted.

At the same time, providers must adopt specific protocols of communication, clarifying how patient data is gathered and exactly where, when and with whom it is to be shared. Senior living providers should also hire a “human navigator,” or a medical concierge, to help schedule and manage residents’ various medical appointments, Katzmann said.

“Instead of treating sickness, we’re about promoting health,” Katzmann said of the senior living industry. “It’s about how to keep people well, rather than how to treat them when they’re sick.”

Juniper’s embrace of value-based care, its use of PointClickCare’s EHR and its employment of a medical concierge, have set the company apart from competing senior living providers — in a good way.

“Reputation is everything, especially when you’re a smaller company,” Katzmann said. Juniper may be a smaller company, but it’s flexible, innovative and has cutting-edge programs, she added.

Other panelists agreed with Katzmann’s point about reputation, and said that consumer choice will remain important regardless of the fate of the ACA. In fact, embracing value-based care may even give providers an enhanced reputation, the panelists said.

“The return is our reputation,” Bill Dillane, president of Toronto, Canada-based The Responsive Group Inc. and PointClickCare’s board chairman, said during the panel discussion. “We believe on a long-term basis that’s just going to make us the home of choice.”

Though fee-for-service may once again become the norm under a Trump presidency, operating as though value-based care were still in favor would continue to benefit American senior living providers, Dillane explained. According to Dillane, senior living communities in Canada that operate on the premise of value-based care tend to bolster their reputations and stand out in competitive environments, despite the fact that Canada has neither the ACA, nor value-based care.

“It’s a very competitive landscape; individuals get to choose which long-term care home they want to go to if they’re in the hospital or if they’re waiting for long-term care after acute care,” Dillane said.

After all, as a service philosophy, value-based care just makes sense, Kim Estes, Brookdale Senior Living’s senior vice president, clinical services, concluded during the panel discussion.

“It just makes sense that we should be paid on the quality, the value that we bring,” Estes said. “I think it’s the best thing, and better for the industry and we’ll have to embrace it.”

Follow the link to hear more about how leaders in the senior care industry, including Lynne Katzmann, are tackling their biggest challenges.

Or hear more stories from SUMMIT 2016.

January 5, 2017