Move Towards Value-Based Care

Value Based Care

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Do you provide value to your residents, in terms of quality health outcomes compared to the cost of that care? Any organization looking to participate in value-based care solutions needs this question answered to understand what this model seeks to achieve. 

Value-based care acts on principles of incentivizing providers and payers to keep costs low, all the while driving high quality health outcomes. 

There is no denying that better outcomes result in better value. Value-based care in senior living incorporates different payment models that keep the focus on quality health outcomes with the proper payment structure in place. Value-based care drives a number of benefits such as:

  • Improved resident outcomes
  • Greater family satisfaction
  • Better operational efficiency 
  • Higher clinician satisfaction
  • Lower turnover
  • Increased cost savings

Senior Living: A Great Platform for Value-Based Care

The main purpose of senior living is to provide the elderly with assistance when it comes to their basic living needs. However, high levels of chronic illnesses and functional impairment among the elderly make senior living a great value-based care opportunity. There are several reasons as to why senior living organizations would be a great platform for this: 

  • Most Medicare beneficiaries with really high healthcare costs reside in senior living. Individuals within senior living mostly face functional impairment or have one or more chronic conditions. This means they have far higher healthcare costs compared with those who do face any functional impairment.
  • Senior living operators need new strategies and incentives for better care.The rapid increase in the aging population has strained senior living facilities, in terms of resident needs not being properly managed. Family members often complain of residents being sent to emergency rooms quite often.
  • Historically, senior living operators have seldom combined their services with a medical care team or a primary care provider. Community medical providers can partner with senior living facility operators, if they want better healthcare for residents at these facilities. For now, very few senior living organizations properly acknowledge resident needs and take to establish partnerships with upstream providers and payers.
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How Can Senior Living Move Towards Cohesive Healthcare? 

Long-term care providers have been actively involved in the care and well-being of the frail and the elderly. While practitioners continue to struggle with rising demands, ACOs carry a promising solution for residents in senior living, all the while improving on the quality of care and reducing the costs involved. 

Most ACOs take part in the Medicare Shared Savings Program, which incentivizes healthcare providers to increase quality patient outcomes while limiting healthcare expenses. The Medicare program is central in the health system moving towards better outcomes and lower costs, with the goal of having all Medicare beneficiaries in a value-based payment arrangement.

There is no denying that providers are faced with multiple challenges in the management of their business and patient care. If they decide to join an ACO focusing on senior living residents, they receive backing from a group of experts dedicated towards helping LTC providers in advancing better care for their residents. 

ACO involvement will benefit providers in the long run. They will feel empowered in properly managing residents’ care needs, such as dealing with chronic conditions, reducing unnecessary hospitalizations and decreasing emergency room visits. Data sharing and better coordination of care will enhance patient outcomes and effectively cut down on the costs involved. 

When taking a decision on ACO participation regarding long-term care population, it is best to choose one that has proven success, in terms of quality improvement, clinical impact and shared savings. 

The Changing Shift in Senior Living: What the Future Holds

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With rising demands in the senior living landscape, partnerships with health systems will prove fruitful, in terms of addressing residents’ medical needs and their overall satisfaction with the process of care delivery. ACOs and MCOs have the chance to work with various senior living organizations, understand who they serve and help them build on the value of care being delivered in their communities. 

The shift in senior living towards greater clinical capabilities is paving the way for there to be more partnerships and collaborations between providers and primary care networks, accountable care organizations and Medicare Advantage networks. Senior living stands to benefit from value-based care as taking part in this will result in better outcomes for residents, their families, operators and investors. 

Covid-19 will only speed up the push towards a value-based care model. Providers who hold such systems in place will find it much easier to navigate their way back to pre-pandemic levels in occupancy, lead generation and net operating income. In addition to this, a clinical component in a senior living facility will lower man hours lost in residents being readmitted to communities after emergency room stays or hospital visits. This will give providers more time and will enable them to work on strengthening relationships between staff and residents.  

According to James Lydiard, (Vice President at Strive Health), a greater number of providers will be exploring value-based care solutions post Covid-19. Most will struggle to find a starting point or think it requires a massive financial undertaking. He suggests that this is not the case.

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Providers can experiment with phased approaches to value-based care, or research partnerships requiring little to no financial investment on the part of the provider. And a growing number of health systems and primary care networks are actively seeking ways to gain a foothold in senior living, which makes it easier for providers to identify a partner.”

Change the senior living landscape and make sure residents receive the highest level of care possible. 

In terms of successfully implementing value-based care in long-term care settings, collaboration with providers is key and stands to benefit everyone involved in the healthcare ecosystem. These consist of hospitals and primary care physicians, with the goal of coming together and developing integrated care models that offer high-quality patient-centered care to residents. With rising healthcare costs, long-term care providers must increasingly look towards value-based care systems that emphasize quality patient outcomes while limiting unnecessary costs.

In the words of Lydiard, “Think about value-based care as a trial. Test, be curious.


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Senior Living: The Biggest Missed Opportunity in Health Care

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