WASHINGTON, DC — The senior living industry is at a critical juncture, making now the moment in time to address improvements in quality, equity and resident outcomes, according to experts speaking Monday at the National Investment Center for Seniors Housing & Care’s 2024 Fall Conference.
Dianne Munevar, vice president of healthcare strategy for NORC at the University of Chicago, said that 60 million older adults — 20% of whom have self-care limitations — are going to be seeking housing and healthcare solutions, but for many, affordability is a challenge. For the industry, she added, the biggest challenge is not having enough trained individuals to meet their needs.
NIC Head of Research & Analytics Lisa McCracken said that the senior living industry focuses on housing, but there is a real opportunity to use data from the NIC-NORC research reports on frailty, access to healthcare, longevity and health outcomes to change the industry’s trajectory and have a different seat at the table.
The senior living industry, she said, can be a solution to the challenges facing older adults, but it needs data, information and research to accomplish that goal.
Senior living’s unique position in risk management
Health outcomes, Munevar said, are extremely important. The Centers for Medicare & Medicaid Services, providers and health plans all are managing outcomes. But CMS, she added, also cares about costs and is working through Center for Medicare and Medicaid Innovation, or CMMI, on dozens of demonstration projects to attempt to solve those problems piecemeal.
Senior living providers, Munevar said, are uniquely positioned not only to understand the clinical risks of their residents but also their mental health and social risks. All of that knowledge, she said, translates to cost savings for the healthcare system.
The challenge for the senior living industry, she said, is taking all of those data gained through active and passive management and pulling it together to demonstrate the sector’s value proposition to CMS and show how providers help to reduce costs.
Munevar gave a preview of NORC’s study analyzing Medicare costs, saying that early findings are promising. Looking at approximately 90,000 Medicare beneficiaries — 28,000 in assisted living and 58,000 in independent living — the data show that the industry’s care for at least a fourth of them is generating substantial savings. More specifically, she said, the data show a 20% reduction in costs for assisted living residents and a 17% cost savings for independent living residents compared with costs for older adults living in the greater community.
“That’s not something to shake a stick at,” Munevar said. “Those are real dollars.”
Although the research is in the early stages of uncovering what the findings mean and how senior living communities are generating savings, Munevar said, much of it comes from lower emergency department visits along with lower hospitalization rates and fewer skilled nursing stays.
Senior living, Munevar said, provides better chronic care management and access to primary and preventive care for residents compared with older adults living in the community at large, which can generate more reductions in healthcare costs. And she said, even with no financial incentives and a challenging regulatory environment, 25% of assisted living and independent living properties combined generated those savings.
“People are doing something right,” she said, adding that CMS has a goal that by 2030, all Medicare beneficiaries will be in some risk-sharing or accountable care organization. “Senior housing needs to get there as soon as possible. This is the moment,” she said.
Selling senior living’s value proposition
CMS, Munevar said, is going to start looking at all stakeholders and determine who has eyes on beneficiaries and who is managing individuals’ health as well as how those organizations can better serve beneficiaries and align with CMS’ goals. Senior living providers, she said, have an opportunity to participate in value-based contracts to demonstrate their ability to provide cost savings.
“Demonstrate you have value and help articulate what a contract could look like before we get to 2030,” Munevar said.
To that end, she issued a call to action for senior living providers to be prepared for a value-based future. “You need to be ready, because this is coming,” Munevar said.
Munevar emphasized that providers need to know and understand their data — and senior living providers have “boatloads” of data, she said — as well as understand how systems are connected, know their local markets, use their data and tell the story about their resident population.
She advised providers to form partnerships to harness their data and tell their stories in a way that explains how they can meet health system needs. Providers must understand advocacy and value-based opportunities and decide their unique value, Munevar said.
Moving forward, McCracken said, the sector is at a crossroads in making decisions about responding to the demographics knocking on their door. “We have some strategic choices to make,” she said.
“The healthcare ecosystem is changing,” McCracken said, adding that senior living needs to be empowered by its seat at the table. “Now is our time.”
More than 2,800 people registered for the 2024 NIC Fall Conference, NIC President and CEO Ray Braun said at a press briefing preceding the session. The meeting goes through Wednesday.
See more coverage of this session in McKnight’s Long-Term Care News.
