Unlocking Value Through Collaboration...Unlocking Value Through Collaboration Collaborating Across...
Transcript of Unlocking Value Through Collaboration...Unlocking Value Through Collaboration Collaborating Across...
Unlocking Value Through Collaboration
Collaborating Across Care Silos to Create Value
GSLA Luncheon April 21, 2017
Presented by Bill Kauffman, Senior Principal, NIC
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Need for Investment in Senior Care Innovation
• We are headed into a major shift in society without needed infrastructure to deliver and integrate health and supportive services to frail seniors and manage the overall financial risk to the country
• We need to create 40 years worth of innovation in 10 years
• Innovation that results in the disintegration of care silos and the integration of senior care
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NIC Conducted Research on Adding Value to Investment Opportunity…
MAJOR FINDING
There are opportunities for adding value to investment in real estate-based care when a senior care organization “innovates” by managing health care for residents or for high-need individuals who
live outside of the property.
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Value That’s Needed as Healthcare Risk Shifts to Providers and Payers
PER CAPITA MEDICARE SPENDING FOR SELECTED GROUPS OF BENEFICIARIES
AGE 65 AND OVER1
Group of Beneficiaries Overall Per Capita Medicare Spending
Lowest 5% of Spenders $62
Lowest 20% of Spenders $331
Highest 20% of Spenders $29,604
Highest 5% of Spenders $59,646
1 This analysis excludes beneficiaries who died during 2006. N = 24,754,479 beneficiaries with any spending, 4,950,896 beneficiaries per quintile, and 1,237,724 beneficiaries per 5%
group.Source: “Data Brief: Medicare’s Highest Spenders.” The Scan Foundation. October 2011. Accessed August 14, 2014. http://www.thescanfoundation.org/publications/databriefs/medicares-highest-spenders
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Research Shows Current Silos Drain Potential Value
PE/VC RE Investors
Home CareCare MgmtTechnology
Primary Care
HousingSNFs
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Operators Need to Connect Across Silos
COMMUNITY CARE REAL-ESTATE BASED CARE
Home care companies express interest in relationships with properties because they offer “great platforms” for acquiring
new customers and gaining market share
Real-estate based care needs to expand capabilities beyond
four walls whether through partnership or buy/build
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Value is Created When Care Silos Break Down
Day-to-Day Functioning
Value
Created for
Frail Seniors
Housing &
Social
Environment
Health &
Medical Care
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Breaking Down Silos Requires Collaboration Across Real Estate and Non-Real Estate-Based Continuum of Care
New Value
Enablers SNFs /
Seniors HousingReal Estate
Investor
VC/PE(Venture Capital/Private Equity)
Clinical & CareIntegration
Value to Insurers, Organizations Taking Risk
NeedCustomers / Platform
Need Capabilities
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Value-based Care is Rapidly Transforming the Healthcare Marketplace
2011
5%
Medicare Fee-for-Service PaymentsLinked to Quality or Value
2016
30%
Accountable Care Organizations(ACOs) and Bundled Payment
Arrangements
Medicare Payments Now Tied toAlternative Payment Models
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Managed Care Enrollment is Growing as Seniors Seek Relief from Medicare Coverage Gaps
2010 20150
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10
15
20
25
30
35
24%
31%
Enrollment in MedicareManaged Care Organizations
(MCOs)
Mounting pressures will
force traditional insurers to
focus more on reforming
care delivery
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Your Population is THE Focus for Organizations Taking Healthcare Risk
11MillionSeniors Receiving Help with Daily Activities
(30% of all Seniors)1
Per capita Medicarecost about 4Xas High
as Non-Frail2Per capita Medicare cost about
3Xas High as Non-Frail2
Seniors Housing/SNFsalready adding value
to Medicare
1 Vicki A. Freedman and Brenda C. Spillman, Disability and Care Needs Among
Older Americans, The Milbank Quarterly, Vol. 92, No. 3, 2014 (pp. 509-541)
2 The SCAN Foundation DataBrief: Di? erences in Medicare Spending by
Disability and Residence, September 2011, DataBrief No. 17.
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Your Organization Will Benefit if it Can Partner with Enablers to Operate Across Silos
VC and PEfunding is flowinginto organizationsthat “enable”managementof high costpopulations
Care ManagementCompanies
Tech-EnabledHome Care Data Analytics
Enhanced PrimaryCare for High Cost
Patients
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Future Returns in Senior Care Depend on Creating Value
InnovativeSeniors Housing
Models
EnablersTech, Home Care,
Primary Care at Home
+
Senior CareOrganizations:
Connecting Frail Seniorsat Home to Primary Care andAlternatives to Hospitalization
VALUE
VOLUME
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Unlocking the Value of Senior Carein a Value-Based World
• Seniors housing is a strong platform for managing the most expensive lives in health care
• But, that value is locked without key partnerships and capabilities, including strategic relationships with (between) health care, post-acute care, and home care
• The NIC Spring Investment Forum will help attendees find the partners, tools, and strategies so they can integrate across the care continuum and drive value for risk-holders in their markets
2017Q1 NIC MAP Data
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Seniors Housing – Primary Markets
78%
80%
82%
84%
86%
88%
90%
92%
94%
-2000
-1000
0
1000
2000
3000
4000
5000
6000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Inventory Growth AbsorptionAll Occupancy Stabilized Occupancy
Seniors Housing Fundamentals
Primary Markets | 1Q06-1Q17
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Seniors Housing - Atlanta, GA
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
-150
-50
50
150
250
350
450
550
650
750
850
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Inventory Growth Absorption
All Occupancy Stabilized OccupancySeniors Housing Fundamentals
Atlanta, GA | 1Q06-1Q17
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Independent Living - Atlanta, GA
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
-100
0
100
200
300
400
500
600
700
800
900
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Inventory Growth Absorption
All Occupancy Stabilized OccupancyIndependent Living Fundamentals
Atlanta, GA | 1Q06-1Q17
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Assisted Living - Atlanta, GA
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
-150
-50
50
150
250
350
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Inventory Growth Absorption
All Occupancy Stabilized Occupancy
Assisted Living Fundamentals
Atlanta, GA | 1Q06-1Q17
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Construction Starts by Segment – Atlanta, GA
0
100
200
300
400
500
600
700
800
2006 Q2 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Assisted Living Independent Living Memory Care Nursing Care
Construction Starts by Segment
Atlanta, GA | 2Q06-1Q17
Questions
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This year’s Fall Conference will be from
Tuesday, September 26 - Thursday, September 28
Registration Opens—June 6
Early Bird Deadline—August 1