Long-term care leaders gathered for a roundtable discussion in Dallas sponsored by Curana.
Long-term care leaders gathered for a roundtable discussion in Dallas sponsored by Curana.

Long-term care providers are turning to value-based care partnerships to give seniors what they really want and need. 

Through these partnerships, healthcare providers can improve patient health outcomes while reducing costs. The key is putting the patient at the center of care initiatives when addressing continuity of care, ancillary services, relationships with providers, technology, and more.

That was the general consensus at a recent special McKnight’s roundtable discussion that explored the opportunities and challenges in advancing patient-centered care. Participants included some of the brightest minds in long-term care today, encompassing provider leaders, long-time sector analysts, and thought leaders who have studied — and indeed compelled — some of the biggest changes of the last several decades themselves.

McKnight’s Long-Term Care News Executive Editor James M. Berklan moderated the event, which was sponsored by Curana Health. 

The evolution of patient-centered care

As senior living communities shift towards patient-centered care, there is greater emphasis on the patient’s day-to-day needs. 

“We’re looking at how we keep those patients out of the hospital,” emphasized Bubba McIntosh, Senior VP of Ancillary Services and Service Line Strategy, for NHC.

Operators traditionally function in a reactive manner when providing healthcare solutions to their residents. In contrast, patient-centered care is preventative and proactive. 

“It’s bringing in a physician practice group, promoting them, and getting a preponderance of residents using them to provide care and services to our residents,” added Alan Fairbanks, President of the Value-based Care Alliance, Serviam Care Network. “They’re seeing residents regularly, and if something happens, they’re in tune with their needs.”

What’s causing this change? 

“A steady growth in the number of health plans being offered to nursing home residents, physician groups anxious to get in under risk-based contracts, and a lot more competition and value,” explained Anne Tumlinson, CEO at ATI Advisory.

Improving resident services can be difficult through the fee-for-service model. “Providers have used the asset model not because they want to get into the insurance business,” Nisha Hammel, Vice President, Reimbursement Policy and Population Health, AHCA/NCAL, said. “It is the vehicle allowing providers the medical and regulatory flexibility to do what they want to do.”

Partnerships are fueling innovation from skilled nursing to affordable senior housing. 

“Forward-thinking partners are saying, what can we do next, what do our residents need, thinking beyond the usual box, not just relying on some of the customary ancillaries,” explained Amy Kaszak, Executive Vice President of Strategic Initiatives at Curana Health.

As a result, “senior living is now in a prized position because they’re providing those services and providing value,” observed Fred Bentley, Managing Director at ATI Advisory.

Addressing the diverse needs of residents

Value-based care (VBC) allows providers to focus on helping people live healthier, happier lives. 

As part of its preventative efforts, NHC seeks to improve the patient’s life with behavioral health services and Institutional Special Needs Plans (ISNPs). Residents are able to receive treatment by a professional on campus — without the dreaded hospital (re)visit — and are able to return home quickly. “We have those patients who are struggling, and they get treated and looped back into their environment,” McIntosh explained.

Coordinated care is critical to better outcomes. 

“We bring the nurse practitioner, the rehab, and the local leadership teams of the community into a conversation to talk about at-risk residents in a meaningful way that breaks down the silos of care,” Fairbanks said.

Ignite Medical Resorts relies on weekly staff meetings, noted April Baltazar, General Manager at Ignite Medical Resorts. “We go through every single person, we each have our positions, and communicate without evangelizing,” she said.

To effect lasting change, healthcare overall must evolve, participants agreed.

“How do we create stability in the entire sector and continuum from hospital all the way to home care to then be able to pivot in a way that enables the execution?” Hammel asked. “If we don’t have that, every model is going to come up against some hiccups.”

The role of technology

One of the biggest technological challenges for healthcare is data. 

“Let’s find six or eight data points that we’re going to measure consistently as an industry,” Fairbanks said. “We don’t have any data to back up what we’re trying to communicate to policymakers.”

Real-time data can also help companies remain competitive. 

“I have to know what I’m spending because I have to be able to pay my bills while also accommodating the fast-paced, demanding guests that come in and out of the building,” Baltazar explained. The How’s Mom app, for example, helps Ignite Medical Records update family members and bridge relationships between staff and family in less time.

Data is also critical to improving patient outcomes, Bob Kramer, Cofounder, former CEO and now Strategic Advisor of NIC reminded. “Ultimately, you can’t move from sick care to well care without being preventative and predictive,” he declared. “And you can’t be predictive and preventative without data.”

Having the right data can be difficult when providers work in separate systems, McIntosh pointed out. “They don’t communicate with the upstream or downstream providers,” he said. “Every hospital that we work with wants a different interface and they want to be able to access our medical records from a different avenue.”

Advancing patient-centered care

One of the biggest hurdles to pivoting to VBC is money. 

“Any person-centered intervention that we’re trying to implement requires financing and a dedicated model that requires scale,” Tumlinson said. “If we can create an enticing senior living and Medicare Advantage product integration, where we finance a lot of the operations of senior living within the context of the Medicare Advantage dollar, from a consumer standpoint, that is such a win.”

Rather than focusing on what insurance will cover, VBC offers healthcare the opportunity to hone in on patient needs. 

“The beauty of VBC is to unshackle yourself from that legacy model and be able to try new things and say, if this technology, if this intervention works, and it has better outcomes, then it pays for itself,” Mark Price, CEO, Curana Health said.

Jeff O’Berry, Executive VP of Growth at Curana Health agreed, “VBC delivers the level of attention, care, and respect that seniors living in senior housing deserve. The biggest obstacle that we have is the fear of change.”

Everyone must keep in mind that person-centered care is different from patient-centered care, participants emphasized. “They want to be people first, patients second, and that means active listening, care plan co-creation, sincere empathy, and making sure that we’re involving other people,” Jeff Micklos, Executive Director for the Health Care Transformation Task Force observed.

It’s also important to rethink the senior living healthcare experience with regard to how seniors in assisted living communities operate day-to-day and how they utilize services, and how this differs from non-community residents, Kaszak said. “There’s some real work to be done about how we make those models contribute to a holistic wellness plan for our seniors,” she stressed.

Ultimately, VBC will not only alter long-term care but overall healthcare as well.

“We need the next generation of operators,” Kramer concluded. “They think differently about transparency, data and healthcare, and the old views on all three of those are inimical to what the private sector needs to do.”

By working together through forward-thinking VBC partnerships, healthcare providers can give patients what they want and need. And in the end, patients will be able to lead healthier, happier lives. Which is really what it’s all about.

Conor McCaw, Chief Growth Officer at Curana Health said that “establishing a high-performing primary care offering is step one for senior living operators to begin participating in value-based care payment models. Operators must find the sweet spot at the intersection of healthcare and hospitality that offers residents a concierge-like service and experience.”

If you would like to learn more about how Curana Health can help prioritize patient-centered care in your community, please inquire at [email protected] for a personal presentation.  For more information, visit Curana Health | Nationwide Senior Living Collaborative Care.

Roundtable participants:

  • Alan Fairbanks, President of the Value-based Care Alliance, Serviam Care Network
  • Amy Kaszak, Executive VP of Strategic Initiatives, Curana Health
  • Anne Tumlinson, CEO, ATI Advisory
  • April Baltazar, General Manager, Ignite Medical Resorts
  • Bob Kramer, Cofounder, former CEO and now Strategic Advisor of NIC
  • Bubba McIntosh, Senior VP, Ancillary Services and Service Line Strategy, NHC
  • Conor McCaw, Chief Growth Officer, Curana Health
  • Fred Bentley, Managing Director, ATI Advisory
  • Jeff Micklos, Executive Director, The Health Care Transformation Task Force
  • Jeff O’Berry, Executive VP of Growth, Curana Health
  • Mark Price, CEO, Curana Health
  • Nisha Hammel, Vice President, Reimbursement Policy and Population Health, AHCA/NCAL