By Jack Cumming
At the LeadingAge California Conference on October 8, 2020, Jeanee Parker Martin, LeadingAge California CEO, chaired a panel of leaders to discuss, “How the Changing Landscape Impacts Your Organization.” The panel members were Philip Chuang, a Clinical Vice President with Kaiser Permanente for Northern California; Molly Forrest of Los Angeles Jewish Home; John Cochrane, CEO of HumanGood®; and Steve Wigginton, CEO of Novuhealth.
Pandemic Accelerates Change
There were certain shared takeaways, some of which were predictable, while others were less so. One predictable insight was that the Medicaid rolls are growing following the economic fallout from the pandemic. Medicaid is the government medical program for the indigent. Less expected was that more and more senior living providers seem to be looking seriously at offering clinical primary care onsite in their communities. All of the panelists spoke of being open to partnerships that can give them access to expertise that they lack now in their organizations.
Molly Forrest spoke of how Los Angeles Jewish Home learned from offering Programs of All-Inclusive Care for the Elderly (PACE) that a Medicare Advantage program could be beneficial for their market-based residents as well. Medicare Advantage plans are private-sector alternatives to government Medicare and are required to offer all that Medicare does and more. They are an option that consumers can choose. PACE programs are Medicare Advantage plans limited to specific Medicaid eligible participants.
The involvement on the panel of Kaiser, which is a large staff model HMO (Health Maintenance Organization) delivering integrated care within a closed system to over 12 million members, shows the growing realization that improving primary care for the elderly is key to improving quality of care while reducing cost. Until recently, Kaiser has not been seriously involved in senior living.
The experiences reported by the panel participants showed growing engagement within senior living toward including primary care and benefiting from the affiliation. During the panel’s question and answer session, Sheri Peifer, Eskaton’s Chief Strategy Officer, echoed Steve Wigginton’s acronym QRS, standing for quantify, replicate, scale, as critical to the evaluation process.
Typical senior living communities do not have the size to allow the kind of integrated care that a large-scale enterprise like Kaiser is able to offer. It’s also essential that pricing and resources be appropriately quantified to match the need. Eskaton has long worked with Kaiser to benefit those residents within the Kaiser system. In February of this year, Eskaton partnered with Kaiser to launch a COVID-specialty unit to provide services to people needing focus to rehabilitate home. That initiative has proven successful. Almost all served in this specialty neighborhood have been able to return home.
What To Do?
Looking at this in perspective, it’s clear that senior living addresses the scope of elder needs while Kaiser has the scale, know-how, and technology to respond effectively. AllyAlign was also mentioned as a Glen Allen, VA business that specializes in assisting senior living providers in evaluating and implementing the Medicare Advantage opportunity.