SAN DIEGO—Study results released Wednesday offer assisted living providers a strategy to reduce emergency room visits, hospital stays and overall healthcare costs.
At the same time, the findings could contribute to an accelerated migration of some patients from nursing home settings to places that traditionally have not touted healthcare services. Such a flow would extend an acuity slide in the healthcare spectrum that has affected virtually all government-funded healthcare programs in recent years.
“The data reveal a tremendous opportunity to reduce hospital-based healthcare services that put seniors’ health at risk and drive costs upward,” said Anne Tumlinson, founder and CEO of ATI Advisory, at the 2020 NIC Spring Conference. “Putting housing and healthcare under the same roof promises better coordination and results.”
She called any hospital visit for a senior — coming from a nursing home or senior living residence — one of the riskiest things they could endure, and, therefore, should be avoided at almost any cost. “Going to the hospital is probably the least safe place you can go.”
NIC President and CEO Brian Jurutka noted that federal officials, as well as consumers, have kept up a steady beat for lower spending and better outcomes. This has led to an acuity slide that has brought more medically complex patients to nursing homes, as well as more medically needy residents to assisted living operators.
“As boomers continue to participate in Medicare, it’s something that the government will continue to move toward — value-based care — in a bipartisan manner. It’s not blue or red,” Jurutka said. “So we see this as an imperative for skilled nursing to figure out how to play in the space, and it’s an opportunity for assisted living.”
ATI Advisory also released an analysis of 2017 Medicare Current Beneficiary Survey data that showed relatively high levels of cognitive impairment (60% in assisted living vs. 75% in skilled nursing) and needs for help with at least two or more activities of daily living (63% in assisted living vs. almost 90% in skilled nursing).
“That’s what we would consider to be a nursing home-level of need, by the Medicaid definition,” she said of the assisted living stats.
In addition, ATI Advisory released figures that showed the share of the nation’s 400,000 assisted living residents 65 or older and Medicare eligible who were enrolled in Medicare Advantage was 29%. That’s a significant jump from the 24% of the nation’s 800,000 nursing home residents in the same demographic who are enrolled in Medicare Advantage.
And although Medicare Advantage enrollment numbers are growing, Tumlinson said that has vastly different implications for skilled nursing and and senior housing classes.
“It’s a disaster for home health and SNFs because it’s all about rate negotiation,” she told McKnight’s in an interview prior to the press conference. “But for senior care, it’s a whole new world.”
The NIC Spring Conference continues through Friday morning and offers seniors housing and care operators numerous education and networking opportunities with capital providers and policy experts in the field.