Beth Mace's presentation at the NIC National Conference as interpreted by an illustrator.

Seniors living operators have some thinking to do about the future, National Investment Center for Seniors Housing and Care Chief Economist Beth Mace told attendees of a session at the group’s national conference Oct. 2 in National Harbor, MD.

Changes in healthcare law, accountable care organizations and the shift from fee-for-service to value-based payments have hospitals seeking relationships with assisted living communities and other long-term care providers, she said. “There’s more talk about the medical model of senior housing as opposed to the social model of senior housing,” Mace said. “If you’re an operator, you have to start to really think about which it is that you are, that you want to be: a medical model or a social model or some hybrid between those two.”

In general, independent living, assisted living, memory care and skilled nursing are a “sweet spot” for investors and operators right now, she said, and the cost of care makes assisted living especially attractive to those seeking care partners. Acute care costs about $1,800 per day in a hospital versus post-acute care at $1,450 per day at a long-term care hospital, $1,314 per day at an inpatient rehabilitation facility, $432 per day in a skilled nursing facility, $190 per day at home with home healthcare or $121 per day in assisted living, Mace said.

“You’re hearing more and more the language that seniors housing is becoming part of the solution for the aging process,” she said. “We sometimes talk about it as a choice-based option. Well, it is a choice-based option, but I think there’s plenty of opportunity right now to…move into the value-based outcomes solution. And there’s no time like now to do it because life expectancy keeps rising.”