A recent National Center for Seniors Housing and Care (NIC) blog post caught my attention about a report from consulting firm Alvarez & Marsal (A&M).
The report, which contains some valuable insights about the entire continuum of senior care, serves as a reminder that post-acute care stands on the precipice of major change. In fact, the opening line of the report alludes to this conclusion: “A&M believes the post-acute sector will be transformed during the next 10 years.”
Titled “Post-Acute Care: Disruption (and Opportunities) Lurking Beneath the Surface,” the report asserts that this transformation will be driven by the IMPACT Act, the Comprehensive Care Joint Replacement (CJR) model, other payment reform initiatives, and the rise of Medicare Advantage plans.
This is not exactly breaking news, I know. But it is yet another signal that providers that serve patients within the entire continuum of care—hospital, nursing home, rehab, hospice, home care—should already be taking the necessary steps to position themselves for a paradigm shift.
That said, A&M’s insights do offer providers some suggested opportunities that could help you thrive in the longevity economy.
Following are my key takeaways from the report:
- Interoperable and integrated data systems will be necessary to ensure that patients are connected with the most appropriate sites of care. The results have the potential to improve care transitions, care coordination, evidence-based guidelines implementation, and cost management.
- Improving patient engagement benefits everyone. But it will take “enhanced patient-provider interaction, the self-monitoring of symptoms, and responding with appropriate actions (e.g., adjust medications, call nurse or MD) when symptom levels indicate a problem,” the report states. Some LTPAC tech companies are acting on this already, including some forward-looking clients of Quantum Age.
- Facility-based management personnel and systems “will need to adapt to the new reality or be at risk for failure,” A&M says. The reason? The shift of reimbursement risk to providers during the transition and afterwards will be very challenging for management, given their traditional focus on providing facility-based care rather than utilization management across the continuum.
- A&M also predicts that home care offers the best “longer-term investment opportunity,” while long-term acute care hospitals will be the worst investment risk. In addition, inpatient rehab facilities, hospice, and skilled nursing facilities offer “selective opportunities.”
- Home care may be a good investment but A&M cautions that an increase in the minimum wage “requires monitoring.”
- Home care may also benefit from shorter hospital and post-acute care facility stays, which are being driven by the growth of at-risk contracts.
- Hospice providers are in a good position, A&M says, thanks to a number of factors, including an increased use of advanced directives, Medicare Advantage penetration, and rising acceptance of palliative care.
- Senior housing (assisted living, independent living, and memory care) have an even more favorable outlook. A&M estimates that unit demand will ramp up by 35 percent for independent living and assisted living between 2015 and 2025. This means that there could be a demand of 30,000 to 35,000 units per year.
- Another insight offered in the report relates to the advent of capitated reimbursement models. It is suggested that providers will have opportunities to form partnerships to advance preventive care for the following conditions: asthma, chronic pain, chronic obstructive pulmonary disease, diabetes complications, hypertension, congestive heart failure, pneumonia and urinary tract infections.
The report also offers myriad stats, figures, and tables that support their assertions.
Accountable care organizations, according to A&M, are “pioneering but not sustainable.” This conclusion is based on CMS reports of the first two years after roll out, as well as a number of challenges, including “governance; data collection, exchange, reporting and analysis; incentive alignment among disparate stakeholders and patient engagement.”
Finally, although you may be tired of hearing about the explosion of aging baby boomers, A&M stresses the importance of differentiating among the “medical, social, and community needs of the different age cohorts,” each of which are of different sizes and therefore will increase at different rates during the next 10 years. As noted in a previous report, baby boomers are not a single, homogenous cohort.
For help tapping into and thriving in the longevity economy, incuding the post-acute sector of healthcare, from experts in the senior living and care field, contact Quantum Age today.