Nothing says commitment like putting money on the table.
Earlier this year, Presbyterian Homes & Services (PHS) bought a 50% stake in a geriatric medical group. The bold move by PHS further advances its vision of how to improve care for frail elders.
“The world is changing,” said Dan Lindh, president and CEO at PHS, Roseville, Minnesota. “Every provider has to look at more integration. It won’t go away.”
PHS owns and operates 47 senior living communities, with five more under construction. The majority of the properties are in the Twin Cities area. The group serves 27,000 seniors, including those receiving home and community–based services.
More services have been integrated into PHS offerings over time. Its Optage division provides home–delivered meals, home care, hospice, and primary care at the seniors’ place of residence. PHS has also partnered with insurers, health plans and physician groups. “We are proactive,” said Lindh.
In the recent transaction, PHS bought a half interest in Twin Cities medical group Genevive. Minneapolis-based Allina Health System retained its 50% ownership in Genevive, which serves about 5,500 adults. Approximately 3,500 of those are in value–based contracts for which Genevive is at risk. PHS and Allina already partner on a joint venture called Interlude, which operates transitional care facilities.
Genevive has 120 employees, including 17 physicians and 23 nurse practitioners who work in teams. Genevive provides services to older adults with complex needs. Most of the older adults are covered by managed care contracts with set payments for services, such as Medicare Advantage Special Needs Plans (SNPs).
SNPs are Medicare Advantage plans designed to coordinate care for a group of high–need individuals such as those who are eligible for both Medicare and Medicaid. The goal is to improve patient outcomes and reduce costs.
Genevive services are already offered at four PHS communities and will eventually be available at nearly every location.
Further advancing its push into care collaboration, PHS plans to roll out an Institutional Special Needs Plan (I-SNP) through the Genevive structure in 2020. An I-SNP is a Medicare Advantage plan that provides services to individuals living in the community, assisted living, long-term care or skilled nursing that require an “institutional” level of care regardless of setting.
Other senior living providers are setting up I-SNPs that combine healthcare and housing.
Referring to his organization’s new I-SNP, Lindh said: “We are taking a comprehensive approach.”
Research shows that 20 percent of health outcomes are linked to where a person lives, said Lindh, and 40 percent to “upstream” behaviors such as diet, exercise and socialization. Only 10% is driven by the traditional healthcare system.
“People under our roof tend to have fewer hospitalizations and on average spend less on healthcare than seniors in the general population,” said Lindh.
He admits forging partnerships with healthcare providers and insurers can seem like a daunting task. But Lindh emphasized several advantages:
- The ability to look comprehensively at the healthcare needs of residents via aggregated medical records.
- An on-site medical staff can provide primary care and care coordination to proactively treat residents to prevent hospitalizations.
- The ability to spend allocated health dollars based on the needs of the residents.
- Stronger brand and census.
- Better resident outcomes.
His best advice: “Every senior living organization has to look at this. Start small. Think about how to connect with the other side of the table. It will only increase the value provided to older adults served and strengthen your brand.”
March 1, 2019