Skilled nursing providers, home health agencies, hospitals, and physician practices are starting to form partnerships to help them better coordinate care within Medicare’s emerging pay-for-performance care models.
But independent living and assisted living communities, like the ones operated by CAST Business Associate Benchmark Senior Living, have been largely excluded from the new partnerships, at least in an official capacity. That’s because their residents use private pay, not Medicare, to pay for housing and assisted living, reports Senior Housing News.
Stephanie Handelson, Benchmark’s president and chief operating officer, has a problem with that scenario.
Many Medicare beneficiaries who participate in new coordinated care models are living in residential communities, she says. That means providers of housing and assisted living could be playing an important role in helping those beneficiaries stay healthy and out of the hospital.
Budding Partnerships
Many housing providers and assisted living communities are already acting as care coordinators, says Steven Littlehale, executive vice president and chief operating office of CAST Business Associate PointRight, a predictive analytics platform for post-acute providers.
These providers are helping residents with complex needs manage care transitions, he says. In the process, they are also playing a role in reducing rehospitalizations, which is critical to the success of new care and payment models.
Benchmark has formally partnered with home health agencies and physician practices at all 52 of its properties, reports Senior Housing News. Typically, the organization controls the quality of care residents receive by putting prospective health care partners through a rigorous vetting process.
As companies like Benchmark begin to partner with physicians and accountable care organizations (ACO), they should be able to maintain the same kind of control over quality, rather than ceding control to ACOs, says CAST Commissioner Peter Kress, who is vice president and chief information officer of CAST Patron Acts Retirement-Life Communities.
To accomplish this goal, providers should strive to become a “general contractor” that manages residents’ care and controls cost and quality, suggests Kress.
Technology is Key to Owning the Relationship
Technology could help providers “own” their relationship with physicians and ACOs, maintains Kress. He recommends that housing and assisted living organizations target their technology investments to the goal of collecting information and developing insights about their customers.
Handelson and Littlehale agree with Kress about the importance of rethinking the role of data in the operation of assisted living, which traditionally has depended on customer relationship management (CRM) software to focus on hospitality. Assisted living’s emerging role in health care requires that providers pay more attention to care-related software, they say.
“We’ve got to … reinvent ourselves if we want to play in this … health care space,” said Handelson. “We have to be able to communicate in the same language (as other providers), and now it’s all very care-centric, whereas before it was hospitality-centric.”
Having care-related metrics will help providers demonstrate that they can help lower health care costs while improving outcomes, suggests Senior Housing News.
Or, as Littlehale put it, “You have to bring a lot of the data with you to be welcome at the party.”