A new report from the International Association of Homes and Services for the Aging explores how nine providers of aging services in the United States, Canada, Europe and Australia expanded their business lines to include the provision of home- and community-based services.
“Residential Provider Expansion into Home and Community-Based Services” is based on a qualitative study conducted by the LeadingAge Center for Applied Research and funded by Sodexo Quality of Life Services. The providers featured in the report include nursing homes; continuing care retirement communities (life plan communities), including First Choice and Well-Spring in the United States; and a CCRC at Home program by Cadbury Senior Living.
“We set out to examine how a diverse group of providers carried out successful expansions into HCBS,” said Natasha Bryant, senior research associate at CFAR. “Our study provides practical information that could help other providers plan and implement similar expansions.”
The participating organizations differed in several ways, including the design of their current HCBS lines, the size of their workforces, the number of clients they served and their primary payer sources. “Despite these differences, organizations shared many of the same aspirations, faced common challenges, enjoyed similar benefits and learned a variety of lessons during the expansion process,” according to the report.
After conducting telephone interviews with all of the participating providers and site visits with two of the organizations, CFAR researchers wrote case studies describing:
- How each HCBS program was developed and what it entails.
- National or regional policies affecting the expansion into HCBS.
- Financial implications of the expansion.
- How providers addressed workforce issues in their HCBS programs.
- How each HCBS program fit into or changed the organizational culture.
- Program outcomes.
- Perceived challenges.
- Lessons learned during the expansion process.
The IAHSA report also examines several common themes that characterized the organizations’ experiences with the expansion process. Participating providers took common approaches to staffing and funding their programs and faced common challenges regarding marketing, competition, workforce development, funding and government policies.
Despite these challenges, however, providers cited many benefits associated with the diversification of their service lines, including:
- Development of relationships between the provider and consumers early in the aging process.
- An enhanced ability to fulfill their missions by reaching a greater percentage of the target population.
- A stronger financial picture for the organization.
The IAHSA report also highlights lessons learned that could help guide other providers planning a similar type of expansion.
“Organizations looking to expand into HCBS have a number of options as they operationalize their plans,” said Katie Smith Sloan, executive director of IAHSA. “We hope they use this report as tool to help with their expansion decisions.”