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So many reports, so little time. That’s the feeling one sometimes gets when hit with a flurry of surveys, research, white papers, and more at what seems like a continuous pace. A report released just last month, however, is worth taking the time to review. Packed with useful information about how states deliver long-term services and supports, it deserves a closer look.

Titled “Long-Term Services and Supports (LTSS) State Scorecard,” the report uses a series of measures to rank states by how well they deliver LTSS. A joint effort among AARP Foundation, The Commonwealth Fund, and The SCAN Foundation, it is described by its authors as a compilation of data and analyses that highlight measures of state performance for “creating a high-quality system of care in order to drive progress toward improvement in services for older adults and people with physical disabilities and their family caregivers.”

Among its many interesting findings is this: Since 2014, nursing homes in many states have registered progress on three significant measures of performance related to the delivery of LTSS, as follows:

• Inappropriate Antipsychotic Use. Almost all states (48) significantly reduced the use of antipsychotic medications that are given “off label” for nursing home residents who do not have the appropriate conditions for their use.
• Long-Term Nursing Home Stays. Most people who leave nursing homes do so in the first few weeks of admission. Once an individual stays in a nursing home for 100 days or longer, they are likely to become permanently institutionalized. About two-thirds of states (35) improved significantly in reducing the percentage of long-term nursing home stays of Medicare beneficiaries that last 100 days or more. There is significant variation between states, ranging from 11 percent of people entering nursing homes in the top 5 states to 27 percent in the bottom 5 states.
• Nursing Home Residents with a Burdensome Transition at the End of Life. One out of four nursing home residents was hospitalized at least once at the end of his or her life in 2013. While more work needs to be done, more than half of the states (29) made significant improvements in reducing potentially burdensome transitions for people who die in nursing homes. The top-performing states are Alaska, Idaho, Vermont, Wyoming, and Hawaii. Louisiana improved the most, with a 14-percentage-point reduction.

States also improved on two other measures:

• Person- and Family-Centered Care. Most states (42) improved significantly on this composite measure. This indicator looks at whether:
  • Family caregivers are assessed for their own needs;
  • States have adopted spousal impoverishment provisions in Medicaid home- and community-based services; and
  • States have enacted the Caregiver Advise, Record, and Enable (CARE) Act to notify the family caregiver before the person is discharged from the hospital and to instruct the caregiver on how to perform follow-up medical/nursing tasks.

• New Medicaid Beneficiaries First Receiving Home- and Community-Based Services. Because many people who enter nursing homes never return home, it is important for state Medicaid programs to provide LTSS to beneficiaries first in their homes and communities if possible, rather than waiting until they go into nursing homes. More than half of the states (29) showed significant improvement in the percentage of new LTSS users who first received services in the community. The eight states with the greatest improvement were Montana, Pennsylvania, Maryland, Iowa, Delaware, Louisiana, Vermont, and Nebraska. However, 30 percent of new Medicaid beneficiaries first receive services in their homes and communities in the bottom 5 states compared with 80 percent in the top 5 states.

States showed the most significant declines in employment rates for people with disabilities and rates of transitioning long-stay nursing home residents back into the community.

One of the most useful components of the report is its individual state profiles, which include each state’s rank compared with other states, as well as rankings for the following measures: affordability and access, choice of setting and provider, quality of life and quality of care, support for family caregivers, and effective transitions.

Each state profile also encompasses a series of data points that project the impact it would have if the state improved its performance to the level of the average of the top-five-performing states. Here’s a look at Maryland’s projections, which was ranked No. 12 overall:

• 108,770 more place-based subsidized units and vouchers would be available to help low-income people with LTSS needs afford housing;
• 72,280 more people of all ages would receive Medicaid LTSS to help them with daily activities;
• 22,386 more home health and personal care aides would be available to provide care in the community; and
• 13,375 more low-/moderate-income adults with disabilities would have Medicaid coverage.

According to the press release accompanying the report, the goal of the report is to “stimulate a dialogue among key stakeholders, encouraging them to collaborate on strategies for improving a given state’s LTSS system.”

If you would like to explore how this report can help your business via a focused approach that is facilitated by experts in the longevity economy, contact Quantum Age today.

A Washington Post article about life expectancy in the United States caught my eye recently—not because it was about how people are living longer (in general, we are) but because there are several places in the country where life expectancy is reversing. In other words, as Reporter Joel Achenbach points out, in many pockets of the United States, life expectancy is more than 20 years lower. “Death rates are going conspicuously in the other direction,” he notes in the article, citing a recent study in the Journal of the American Medical Association.

There are of course a number of reasons why this indicator is troubling, but as a disciple of the longevity economy, I find it particularly unsettling given the massive opportunities that aging services innovators have and continue to offer older adults and their families and loved ones.

According to the JAMA study, “much of the variation in life expectancy among counties can be explained by a combination of socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors.” Reversing the trend of increasing disparities may be helped by “policy action targeting socioeconomic factors and behavioral and metabolic risk factors,” the authors point out.

In his article, Achenbach points to other research showing that the United States is failing to keep up with improvements in longevity seen in other affluent nations. “In 2013, researchers described what they called a ‘health advantage’ in the United States when compared to peer countries,” he writes, adding that more recent research has focused on “diseases of despair” that have contributed to a precipitous rise in death rates among midlife working-class whites.

I appreciate that Achenbach calls attention to this issue. And although I am not an epidemiologist, it seems to me that with all of the shiny new technology and innovations coming from our beloved field there should be some fundamental steps we can take to include everyone in our journey toward longevity and leveling these disparities.

That said, there are also plenty of opportunities for aging services entrepreneurs to take on this challenge with success.

If you want a focused approach, facilitated by experts in the longevity economy, as well as honest feedback, contact Quantum Age today.

Until fairly recently, the terms “innovative start-ups” and “aging services” have not historically been uttered in the same sentence. But that’s changing thanks in part to groups like Aging 2.0. The relatively new organization has made great strides in bringing innovation to community-based and long-term and post-acute care in the last couple of years by way of matching investors with entrepreneurs in the space. If you need proof, look no further than their recent report on the state of global innovation in aging services.

The report is a compilation of “innovations and innovators” selected from among its global network of chapters. The report validates that the field does indeed (finally) have a significant number of innovators who are working hard to improve elders’ lives with new and inventive technology, services, and care.

Here are some startups that from the review that caught my eye:

Neeuro: A social enterprise startup from Singapore that uses neurotechnology and gamification to “improve the mental well-being of communities of various age groups” Neeuro’s differentiator is that it combines software with a consumer-friendly wearable that measures the brain’s reaction to games and activities, and then adjusts individual experiences to fit the specific needs of each user. They claim that their technology helps elders maintain neurological health, which thereby prolongs “their ability to interact and engage with others.”

MaturiJobs: From the Netherlands is an online platform that matches seniors with employment and volunteer opportunities The startup claims that it “helps people over 50 find opportunities to generate income and be active—empowering them to maintain a broader set of social roles that can strengthen both their social networks and overall health.”

NeuroTrack: This U.S. company has a web-based test, known as Imprint Check-Up, that people can take on their own computers, using their existing built-in camera or an external webcam. It’s billed as a five-minute assessment that uses eye-tracking technology to detect signs of declining brain health—“even before someone starts to have symptoms.”

Breezie: A “senior-friendly” interface for tablets that can be customized for individual use. According to the website, U.S.-based Breezie creates simplified versions of “everyday services such as email or Skype” so that friends and families don’t have to change “how they keep in touch.” It also has a Caregiver’s Hub that is a portal for managing content and apps on Breezie, which can be accessed from any computer, tablet, or smartphone.

Daughterhood: A U.S. nonprofit organization whose mission is to support and build confidence in women who are managing their parents’ care. Its website, blog, and social media links are designed to connect caregivers to resources and a “wholly unique perspective on our health and elder care systems.” The site also offers a plethora of resources on topics that range from Medicare, end-of-life care, finances, and family dynamics.

Roobrik: Online decision tools to help patients and their families make difficult health and care choices “with clarity and confidence.” The U.S.-based site has assessments that help caregivers identify care needs and options, and support more informed decisions. The site has a step-by-step guide that starts with who the user is trying to help, such as a husband, wife, or father, then takes you through a series of questions and that results in a Care Needs Score. I did it myself using a hypothetical husband in need and it resulted in an “Elevated” score. Along with the score are a list and explanation of potential needs and recommendations for getting assistance or care.

Highlighted in the report is Aging 2.0’s 2016 Global Startup search, which was held across 33 cities in 25 countries. The culmination of this search was the organization’s OPTIMIZE Conference in San Francisco last year (which I reported on it HERE), where winners from around the world were selected by a panel of judges. 

In addition to identifying ten trends in global innovation, the report includes an interesting section that examines startups in the context of how they boost social inclusion among elders. The authors classify the companies based on “three primary classifications of social support: type, direction, and source.” These classifications are then broken down further into more detailed categories. For example, the “Type” classification of a startup specifies whether it offers Emotional or Instrumental support to elders.

The report is relatively comprehensive and worth a look, whether you’re working on an innovation yourself, looking for one, or just interested in what’s out there.

If your innovation needs a focused approach, facilitated by experts in the longevity economy, as well as honest feedback, contact Quantum Age today.

The final rule on the requirements for nursing homes to participate in Medicare and Medicaid is a bit of a behemoth, but it’s an important one since it touches nearly every aspect of a facility’s operations. In particular, there are many implications—as well as opportunities—within the longevity economy, especially for vendors in the long-term and post-acute care space.

Thanks to the agency’s willingness to meet with providers and educate the public about the rule, we have an idea of what to expect from it, current politics notwithstanding. Karen Tritz, head of the Centers for Medicare & Medicaid Services’ (CMS’) Division of Nursing Homes, offered an inside scoop on the rule at the Jan. 31 meeting of the Advancing Excellence in Long Term Care Collaborative (AELTCC).

Other than the fact that the requirements have not been updated since 1991, Tritz reported that CMS overhauled the rule to further advance its efforts in person-centered care and resident quality of care and quality of life. “Think of rule as raising the bar on quality,” she said.

The first thing to know about the rule is that it will be rolled out in three phases. The deadline for implementation of Phase III is slated for November 2019 (Phase I, which ended Nov. 28, is allegedly complete).

A look at some of these requirements should tell you that some of them may not be easy for providers to track or even implement. Vendors should seize this opportunity to develop solutions and innovations that can make providers’ and operators’ work easier:

• New interpretive guidance, as contained in the State Operations Manual (SOM). An advance copy of the SOM will be available to the public early this summer. It will also include an overhaul of the F-tag numbers.
• Development and testing of a new survey process will begin.
• Implementation of the Quality Assurance and Performance Improvement (QAPI) program.
• Update of infection prevention and control programs, which requires an infection-prevention and control officer and an antibiotic stewardship program that uses antibiotic-use protocols and a system to monitor antibiotic use.
• Care planning improvements for discharge planning for all residents, with involvement of the facility’s interdisciplinary team and consideration of the caregiver’s capacity; giving residents information they need for follow-up after discharge; and ensuring that instructions are transmitted to any receiving facilities or services.

• Finalization of the QAPI implementation and discharge planning and infection control requirements.
• Implementation of the requirement that call lights must be present at the bedside of all residents.
• Implementation of new compliance and ethics programs to bring current programs into compliance. Programs must include written policies and procedures to reduce criminal, civil, and administrative violations and must be reviewed and revised annually. For organizations with five or more facilities, programs must include annual training, a compliance officer, and a designated liaison located at each facility.

There are obviously a number of provisions where long-term and post-acute care vendors, such as software solution providers, consultants,  and more can offer solutions and opportunities to make navigating the process easier.

It’s also worth noting that as the rule is rolled out, CMS will implement a new, common survey for all providers by the end of Phase III. The new survey will include elements from both the traditional and the newer Quality Improvement Survey process that has been implemented in more than two-dozen states since 2007. Also part of the new survey will be “new and innovative approaches” and a “balance between structure and surveyor autonomy,” Tritz noted.

I will post more updates as implementation of the rule moves forward. In the meantime, you can read the entire rule here.

If you want a focused approach to creating innovative solutions for elder care, facilitated by experts in the field and candid feedback, contact Quantum Age today. 

File this one under “never knew this group existed but what a cool idea”: The Consumer Technology Association Foundation, a public foundation with the mission to link seniors and people with disabilities with technologies to enhance their lives. Yep, they exist and they published a report that found, among other things, that “meeting the needs of a growing aging population will require new technologies, partnerships, ideas, and business models.”

Ok, so that’s not much of a revelation to those of us entrenched in this field. But read on, it gets better.

The report, titled “Outthink Aging,” also examines how technology will empower seniors to live longer, healthier, and more independent lives by preventing fraud and abuse, providing greater social connectivity, and improving access to vital information and services. Reaching all of these goals remains to be seen but they are worthy.

Among the more salient points made in the report is that technology is just part of the answer to addressing the complex challenges of an aging population. More innovation is needed in our field and technology is just one piece of this puzzle. Amen, and as the report aptly notes, “the aging population is not a user group.”

Human needs are complex and not easily met through technological fixes alone, it further states. The trick is to engage this cohort by “leveraging technical innovation and human empathy to enhance the human experience.”

I’m not sure what engaging “human empathy” looks like, but I understand where they are going, and I would add that the best way to create new innovations that meet the needs of an aging population is to develop the technology with elders and individuals with disabilities—not just for them.

In addition to some great ideas about innovation and technology, the report also notes that activities of daily living are “activities that happen on the surface of day-to-day life.” The groups offer a new list of “core desires of an aging population,” as follows:

• Health: Access to high-quality healthcare encouraging both physical and cognitive wellbeing.
• Connection: Capability to stay in touch with loved ones and maintain an active role in their communities.
• Security: Ability to live safely in one’s home and have protections against theft and financial fraud.
• Dignity and Independence: Respect and control over direction of their lives.

Also notable is the fact that the CTA Foundation collaborated with IBM to create the report. IBM seems pretty happy about it: “[It] is an excellent example of the new types of relationships that will be necessary to meet the needs of the growing aging population,” Dr. Ruoyi Zhou, director of IBM Accessibility Research, says in a statement. He’s right—new types of relationships will be a crucial factor in addressing the needs of elders in useful and innovative ways.

Stephen Ewell, executive director of the CTA Foundation, is also on board. In the same statement, he asserts that “new partnerships between industry, nonprofits, academia, government, and the general public will form to accomplish these goals.” He’s right, and I’m happy to see that more and more folks are getting it.

In addition to innovative ideas and collaborations, the two groups conducted an informal poll at last year’s Consumer Electronics Show (N = 300 to 400) to gauge attendees’ concerns about the challenges of aging:

• 47 percent of respondents worry most about losing their memory and suffering from dementia as they age.
• 38 percent believe smart homes and the Internet of Things will best help manage the aging process.
• 35 percent believe discussing assisted/long-term care is the most difficult conversation to have with their parents.

The report also cites other research from the foundation showing that the U.S. market for active aging technology now encompasses 85 million Americans, representing a $24.4 billion market opportunity in 2015 that is expected to grow to $42.7 billion by 2020 (more from AARP’s report on the longevity economy HERE).

In conclusion, I believe this report is a great resource if you’re interested in dipping your toe into the field of aging services or if you are already in it and need a refresher or energizer on innovation and resources.

If you want a focused approach, facilitated by experts in the senior living field and candid feedback, contact Quantum Age today. 

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.

No matter how often the stats about the impending wave of aging Baby Boomers are cited, it seems that senior living providers, policy makers, and even society as a whole have yet to heed them.

A session at the recent LeadingAge conference highlighted this fact, and the presenters’ message was clear: if you don’t do something now to shift your paradigm and focus on consumers’ needs and desires, among other things, you will miss out on a golden opportunity to not only thrive in the longevity economy but also stay true to your organization’s mission.

Mark Andrews, co-CEO of Irving, Texas-based Greystone Communities, led the session, which was aimed at identifying opportunities and challenges for providers while at the same time maintaining a margin that “enables long-term mission growth.” According to him, the current landscape of the industry is as follows:

• High growth curve and a demographic shift;
• A long economic recovery;
• A strong real estate market and improved household wealth;
• Low interest rates;
• Increasing competition;
• Evolving and changing customers;
• Aging CCRCs; and
• A growing number of providers.

Historically, Andrews noted, providers have had a paternalistic approach to their business model. “We knew what was best for the consumer and we would make it available when we thought they needed it.” With that, Andrews outlined some things that providers should do (and know) to ensure success going forward: 

1. Your business model needs to change to be more consumer-focused and resident-centered. The new model, Andrews explained, must wrap the continuum around seniors’ needs and offer services “when they think they need it,” versus the provider making that decision.

2. Communities with lifestyles of engagement, purpose, and connectedness will thrive. In addition, you will have strong demand if you have the right product, right location, and the right approach to services.

3. Services need to be priced in a way that suits the consumers’ economic circumstances. It will require a different mindset and the ability to serve the upcoming generation of seniors, who will want much more flexibility and programming than the current model offers.

4. The labor pool will be a significant factor. Movement to a $15 minimum wage will affect providers’ ability to recruit and retain staff. “It will have a profound impact on the economics of senior living and your ability to afford it,” which will lead to some stress, said Andrews.

5. Reinvest and remodel your aging physical plant. One-quarter of all CCRCs are between 20 and 35 years old and 22 percent are between 15 and 25 years old, while 12 percent are more than 35 years old. Knowledge is power in this case, Andrews noted: if your CCRC is relatively young, you will have an advantage over most CCRCs in the country.

6. A large number of replacement independent living units will be required over the next 15 years. Between 175,000 and 200,000 additional incremental and replacement independent living units will be needed between now and 2030 to keep up with replacing aging physical plants as the demand for them grows.

7. Competition is on the rise. A growing number of providers nationwide are investing in expansion and repositioning and/or growth. Behind this development are the following factors: more capital availability, aging communities, and growth in for-profit rentals in assisted living, memory care, and more.

Whatever your tax status, it’s a good idea to consider how you might strategize and reposition your community—time may not be on your side if you wait much longer.

If you want a focused approach, facilitated by experts in the senior living field and honest feedback, contact Quantum Age today.

We all know by now that the next two decades will bring on a surge of older adults—to the tune of nearly 79 million people over the age of 65 in the United States alone. But did you know that only 1 percent of the current U.S. housing stock offers the five design elements that would allow older adults to live comfortably? Yes, that’s 1 percent of homes that have zero-step entrances, single-floor designs, wide halls and doorways, electrical controls reachable from a wheelchair, and lever-style handles on faucets and doors, according to recently released study by Harvard University.

In other words, current available housing will not be sufficient to accommodate the aging Baby Boomer population over the next 20 years. With one in three households headed by someone over 65, more people will need to invest in accessible homes with modifications and improvements, but only a small percentage of homes offer those conveniences.

If ever there were an opportunity for enterprising and innovative aging services mavens to jump into the longevity economy, I would say this is it.

According to Chris Herbert, managing director of the Harvard Joint Center for Housing Studies, “the housing implications are many, and innovative approaches to respond to growing needs for housing that is affordable, accessible and linked to supportive services will grow exponentially over the next two decades.”

The study, titled “Projections and Implications for Housing a Growing Population: Older Adults 2015-2035,” also notes that “public investment and private sector efforts to expand access to affordable in-home supportive services will be critical going forward.”

Promising pilot and small-scale programs exist, such as changes to government health insurance programs to cover the cost of in-home care, home modifications, or supportive services to remain in the community, the study notes. But the report warns that the challenge going forward will be to bring successful demonstrations to scale.

Here’s something else you may not know: By 2035, 27 million older adults will earn less than 80 percent of the median income in their area—up from 15 million in 2015. The number of households that own or rent and are severely cost-burdened—defined as paying more than half of income on housing costs—will more than double, according to the report.

Indeed, there are things that the government and the private market can do to prepare for and contribute to resolving these problems. In addition to creating more affordable and accessible housing options, the study recommends offering more assistance to older Americans who are burdened by the cost of housing, increasing subsidies to older renters, and more frequently integrating housing and health care.

It may not seem as glamorous as an HGTV reno show, but now is a perfect time for innovation, design, and aging enablement to come together to resolve the impending housing crisis. Creating and retrofitting homes that are age-friendly is now critical, so I would recommend that my aging services colleagues—as well as intrigued outsiders—take the opportunity now to learn more about it. 

A new report from AARP is taking the long view on the longevity economy with its astute observation about Gen Xers and Millennials. By 2050 these cohorts will join the 50-plus age group. This of course is not rocket science—you can do the math. The point is that the opportunities driven by these groups, including the products and services they purchase and the additional economic activity this spending generates will extend into the latter part of this century.

In other words, the longevity economy and the opportunities it presents will be around for a very long time.

Today, the 50-plus cohort is comprised of approximately 35 percent of the U.S. population, and it crosses four generations:

• The GI Generation, born between 1901 and 1926 

• The Silent Generation, born between 1927 and 1945 

• Baby Boomers, born between 1946 and 1964, and 

• Generation X (Gen X), born between 1965 and 1980—the eldest of whom turned 50 years old in 2015 


Titled “The Longevity Economy: How People Over 50 Are Driving Economic and Social Value in the U.S.,” the report notes that the number of adults age 50 and older is projected to grow by 45 percent between 2015 and 2050, while the under-50 population will increase by just 13 percent. As a result, the 50 and older crowd’s share of the total population will reach 40 percent.

“As the size and productivity of this cohort increases over time, so will the economic returns,” the report states. That’s a big deal—a very big deal. Here are some more stats about the 50-plus age group that underscore the enormity of this group’s impact:

• They hold a whopping 83 percent of U.S. household wealth;
• They spend more overall than their under-50 counterparts;
• They account for a majority of the spending
 in several categories of goods and services, including healthcare, nondurable goods, durable goods, utilities, motor vehicles and parts, financial services and household goods;
• Their direct spending on consumer goods and services, including healthcare, amounted to $5.6 trillion in 2015, while the under-50 population spent $4.9 trillion during the same period.

Notable in the report is that, while white people now make up the majority of those in the longevity cohort, immigration and birth rates by race and ethnicity will change this picture in the coming years. According to the U.S. Census Bureau, by 2050, Black, Hispanic, Asian, and other non-white groups will make up 45 percent of the 50-plus cohort, compared with 26 percent in 2015.

Also interesting is AARP’s analysis of the Internet of Things (IoT), which is defined as “the network of connected, electronic devices able to transmit data in real time—and its transformative potential, offering a new market opportunity, social benefits and cost savings.”

AARP asserts that even within the context of IoT, there is a major market opportunity in the challenge of providing high-quality healthcare at a lower cost. According to the report, venture capitalists invested some $18 billion in start-up healthcare businesses in 2015—a 350 percent increase from 2010. These investments range from coordinating care services and improving clinical workflows to mobile health care, smart homes, “ambient assisted living” and the use of big data analytics.

Whatever the product, solution, or service you offer within the longevity economy, Quantum Age Collaborative is dedicated to helping create innovative and unique solutions that tap into this opportunity to meet consumer demands in new and relevant ways.

If you want a focused approach, facilitated by experts in the senior living field and honest feedback, contact Quantum Age today.

Payment reform is the new driver of innovation in long-term and post-acute care, according to Laurence Gumina, CEO of Columbus-Ohio-based Ohio Living (formerly Ohio Presbyterian Retirement Services). He conveyed his message via a session at the LeadingAge annual meeting last month, along with his colleague, Wendy Price Kiser, executive director of Ohio Living Home Health & Hospice of Greater Toledo.

Gumina recently led the organization through a new strategy development and name change, and the results are indeed innovative. With 12 life plan communities, a home health and hospice care agency, and a foundation under its umbrella, Gumina says he wanted to step outside the boundaries of a typical model and create an innovative value proposition that would be effective in moving the organization into the new world of value-based purchasing.

What’s more, Gumina saw the writing on the wall; he knew he had to be proactive about adapting to the new payment reforms before it was too late. Another significant factor in Ohio Living’s drive to be more innovative is the impending SNF readmission measure that takes effect fiscal year 2019.

The most interesting of Ohio Living’s new models, in my opinion, is its successful home health and hospice services. Branded as the Home to Stay Program, it was created to improve quality and reduce hospital readmissions for patients.

In outlining Home to Stay’s highly successful relationships with two ACOs, Price Kiser noted that although it took their first partner six months to respond to her call, the care coordination model is now a valued component in the ACO’s continuum. “We told them that we wanted to work with them and that we would see all of the discharges coming out of the hospital,” said Price Kiser. Yes, she said ALL of their discharges. It was a risky offer to provide free transitional care to some patients but they bet on the fact that it would enhance their value proposition for the ACO--and it worked.

And like many creative and innovative models that are rooted in everyday common sense, so too is Ohio Living’s. As Price Kiser said: “It isn’t rocket science.” With some “basic clinical judgment” baked into the program, she pointed to a simple yet critical factor in their model: caregivers meet with the patients the very next day after they are discharged. In addition, they focus on two things: medication safety and medication reconciliation.

Here’s how it works:

• Day 1-Coach Visit: The patient signs a consent form, the caregiver conducts a medication reconciliation, takes vitals, creates a personal emergency plan, does a fall risk assessment, confirms a follow-up appointment with (and transportation to) a primary care provider.
• Day 8 – Coach Visit: Review any red flags, determine signs and symptoms and coach interventions, follow up on any issues identified during the first visit, review medication plan, and determine if any PCP appointments and medication changes are necessary.
• Day 17 – Coaching Call: Confirm a PCP visit was made and discuss the results of the visit.
• Day 22 – Coaching Call: Determine signs and/or symptoms and coach interventions, if necessary.
• Day 30 – Coaching Call: Determine signs and/or symptoms and coach interventions and discharge from the program.

As of October, the cumulative hospital readmission rate was 3.6 percent, Price Kiser reported.

Also successful is Home to Stay’s involvement in a Comprehensive Joint Replacement model. Similar to its ACO model, tracking metrics and a focus on patient engagement and education are key to preventing avoidable readmissions under the CJR, Price Kiser said.

The two presenters offered some additional advice for providers seeking their own secret sauce for innovation: Create a value differentiator—something that makes your organization memorable; seek new and unique partnerships; and, last but not least, track metrics, analyze them, and share that data with potential partners.

If you want to create innovative new services or business lines, facilitated by experts in the senior living field, with candid feedback, contact Quantum Age today.