LeadingAge California and Richmond, VA-based care management company AllyAlign Health are partnering to offer Medicare Advantage special needs plans to cover long-term care residents across the continuum of care.
Align Senior Care offers two Medicare Advantage plans providing a care delivery model and plan benefits tailored for senior living residents with complex, chronic health needs. The plans were created in collaboration with LeadingAge California member organizations that participated in a series of design sessions.
One of the resulting plans, Align Connect, is a chronic conditions special needs plan meant to serve residents living with dementia. The other, Align Thrive, is an institutional equivalent special needs plan that serves older adults requiring care in a congregate or institutional setting. Both plans tailor benefits for LeadingAge California member community residents and other older adults served through home- and community-based service settings such as assisted living communities.
AllyAlign Health CEO Mark Price said the LeadingAge California-banded Align Senior Care plans are “designed for senior living residents by senior living communities” to cover residents with complex care needs at all levels.
“Assisted living, memory care and independent living residents with a dementia diagnosis — or requiring assistance with multiple activities of daily living — are eligible, as are long-term residents in skilled care settings,” Price told McKnight’s Senior Living. “These plans are tailored for each community based on the needs of their residents.”
AllyAlign Health also worked with some of LeadingAge California’s 700 members to help ensure that plan benefits and copayment structures would add value and “fit” the specific needs of community residents, Price said.
For example, he said, the plans include a post-hospitalization personal care benefit designed to ease the transition back to home (wherever home is) and support caregivers during transitions. Zero-dollar plan premiums and no copayments for primary care services, as well as low out-of-pocket maximums, are meant to “help seniors on a budget save on healthcare,” Price added.
“The plans focus on providing safe, on-site primary and preventive care for our members,” he said. “They make care more accessible, affordable and comprehensive for residents and provide more resources to senior housing communities and their staff.”
The partners said the plans offer a straightforward path to value-based care that includes funding for services through a Medicare Advantage plan, as well as a proven care model designed specifically for senior housing residents and the providers who care for them.
“We feel that this partnership, which offers tailored benefits that are specific to our members’ settings, is extremely advantageous to the residents we serve,” LeadingAge California Chief Government Affairs Officer Eric Dowdy told McKnight’s Senior Living. “It is hoped that benefits will be maximized by pairing care needs with the options included in these two plans. We expect to see a lot of interest in the plans as we begin our rollout.”
Palm Village President and CEO David Reimer said he anticipates improved outcomes and resident satisfaction with the high-tech care model.
“We are confident the tailored delivery will improve our residents’ access to care and we expect a decline in hospital admissions,” Reimer said. “This will improve our residents’ standard of living by allowing them to age in place.”
AllyAlign Health also has a Medicare Advantage special needs plan partnership with Bloomfield, NJ-based Juniper Communities.