[Partner Content] How Medicare Advantage plans can improve your residents’ experience with more supportive, holistic care
Coming out of the pandemic, there’s been a lot of focus on reimagining the traditional assisted living model to improve the resident experience and meet the changing demands of aging baby boomers, who increasingly want more supportive care without having to move into skilled nursing.
According to a recent article in JAMDA, the Journal of Post-Acute and Long-Term Care Medicine, rates of chronic illness in assisted living communities are roughly one-quarter to one-half the rates among nursing home residents, underscoring the need for a holistic blended model that includes social and medical elements.
But the ability to provide more medical and whole-patient focused services varies widely from facility to facility.
That’s where Medicare Advantage plans are proving to be what the Advisory Board calls the biggest disruptor in the senior care landscape. The plans offer new opportunities for senior communities to provide in-home, affordable, higher- level and more patient-centric health care services.
“The senior living space, I think, is going to dramatically change over the next 10 to 15 years,” said Dr. Kyle Kircher, Senior Medical Director for Optum Home and Community, which oversees the company’s United Healthcare® Assisted Living Plan and Optum care model. “And to keep up with those changes, partnerships are going to be key.”
Special needs plans: Improving the resident experience
While special needs plans for skilled nursing have been around for decades, similar Medicare Advantage plans for senior living residents are newer. But these Institutional Equivalent-Special Needs Plans, or IE-SNPs, are growing quickly.
IE-SNPs are improving the resident experience by bringing advance practice clinicians, behavioral and mental health specialists, social workers, therapists and care navigators directly into senior communities.
“One of the biggest changes we are seeing now is more and more provider groups are going into those settings to provide care as opposed to making those individuals have to come to the clinic,” he said.
Reimagining senior care through IE-SNPs
As an innovator in senior care, Optum offers one of the leading and fastest growing IE-SNPs, the United Healthcare® Assisted Living Plan and Optum care model, which is focused on improving the resident experience through its comprehensive and holistic approach.
Here are some of the things to look for when introducing a care model in your community:
Dedicated coordination
Care navigators. Specialists who help clinical teams deliver all the services your residents need. Whether that’s arranging transportation, making sure follow-ups with specialists are scheduled or helping residents and communities maximize their use of services.
Clinical care teams. Clinicians who know your residents and closely track their unique medical, social, and mental and behavioral health needs.
Reduction in hospital visits
24/7 medical support line. Ensure the care model has round-the-clock medical support, because issues don’t just arise between 8 a.m. and 5 p.m.
Proactive rather than reactive care. It’s important to have clinicians who coordinate and collaborate closely with your staff to help identify issues early, before they become more serious.
Medication management. The Advisory Board study says adverse drug effects from poorly managed polypharmacy are the leading cause of hospital readmission among seniors. Care teams should closely track all of their members’ medicines regularly.
Helps your community offer more services, additional support
More eyes and ears. Care teams with an on-site presence and in-depth knowledge of member residents provide often staff-strapped communities with an extra layer of support.
Treating the whole patient. In addition to regular in-house visits focused on residents’ physical needs, care teams should screen closely for changes in behavior, mental health issues like depression and anxiety, as well as social and financial concerns that can negatively impact health.
Optum: On the leading edge of senior care disruption
According to the Advisory Board, enrollment in special needs plans grew 15% between 2020 and 2021. And it expects demand for special needs plan to grow rapidly over the next 10 years as baby boomers age more deeply into their retirement years. This will be especially true for IE-SNPs, as older adults look ways to avoid living in more structured institutional settings.
“Despite some innovative and promising models of AL (assisted living), there is general consensus that overall, the current model of AL has been taken as far as it can go,” the JAMDA report concluded. “As a society, we are asking AL to be a product very different than its original roots.”
Optum is providing that needed disruption with its innovative and expanding care model, which melds the social with the medical and behavioral aspects of senior care and improves the resident experience by providing quality, affordable in-home health care services.
“A huge part of our model is the caregiving and guidance that we bring into communities,” Kircher said. “And we are on the leading edge of developing new programs and different types of services that meet seniors’ growing demands for proactive, comprehensive, holistic care that can keep them in their communities longer.”
Learn more about how this patient-centric model can benefit both you and your residents bydownloading the full white paper here.
