The devil is in the details, as the saying goes, but President Trump’s call for changes to the Medicare program could mean some good things for senior living residents and the providers who serve them, Juniper Communities founder and CEO Lynne Katzmann told McKnight’s Senior Living.
The executive order signed by the president on Oct. 3 gives the secretary of Health and Human Services a year to develop a regulation “and implement other administrative actions” to “provide beneficiaries with more diverse and affordable plan choices.” The order calls for changes to Medicare Advantage benefit structures and plan designs, a payment model that adjusts supplemental MA benefits to allow Medicare beneficiaries to share more directly in savings from the program, and assurance that “[fee-for-service] Medicare is not advantaged or promoted over MA with respect to its administration.”
Rebates and other new financial incentives, as well as modification of the value-based insurance design model to remove disincentives for MA plans to cover items and services not covered by fee-for-service Medicare, could increase the competitiveness of the MA plans.
Steven Littlehale, chief innovation officer for Zimmet Healthcare Services Group, told McKnight’s that the move is “clearly away from FFS and toward alternative payment models.”
“I hate to see MA politicized this way,” Katzmann said. “The move to value-based care has been miraculously largely bipartisan over the last several years — one of the few areas where Democrats and Republicans have agreed,” she added, pointing to the Medicare Access and CHIP Reauthorization Act of 2015 and the Improving Medicare Post-Acute Care Transformation Act of 2014 as examples.
Bloomfield, NJ-based Juniper previously announced that it is forming the Perennial Advantage Plan with Christian Living Communities, Ohio Living and care management company AllyAlign Health. It’s one example of the increasing role that Medicare Advantage is playing and will play in senior living.
The day before the president signed his executive order, for instance, 10 senior living and care organizations in the Minneapolis / St. Paul area announced that they will offer a new HMO institutional special needs plan to their residents effective Jan. 1 in what plan collaborators believe is one of the largest rollouts of a I-SNP in the country. And just days before that, Toledo, OH-based real estate investment trust Welltower announced a collaboration with CareMore to introduce residents in Belmont Village and SRG Senior Living communities in Los Angeles and Orange County, CA, to Medicare Advantage I-SNPs offered through CareMore’s partnering health plans.
Despite the politics around the federal government’s actions, Katzmann said, “the new flexibility will be good for senior housing providers seeking to provide lifestyle management services that control chronic illness, improve quality of life and contain costs. By providing reimbursement, we offer more older adults the opportunity to improve quality of life while helping to contain healthcare costs by carefully managing chronic conditions and providing quick and efficient intervention before expensive hospital care is needed.”