Senior providers have adopted a private payment model which offers a steady control and financial opportunity based on service-enriched housing facilities. Even though this approach has seen immense success, seniors are looking towards newer options. Senior housing acknowledging mainly independent and assisted living has intentionally selected the private pay model to avoid any federal oversight or reimbursement risks.

medicare housing benefits for senior members

Every year, the Centers for Medicare and Medicaid Services announce various adjustments to the compensation and regulation of Medicare Advantage plans for the next year. Medicare housing benefits is allowing in-home and home-based care services as assisted living benefits for seniors.

The shift in value-based care towards assisted living for seniors, chronically ill, and people with low wages have acted as a catapult to financial options.

For seniors and others, living and aging in a place are just not confined to enjoying the security and familiarity. It is also about electing an option that provides financial aid. The U.S. Department of Housing and Urban Development, aging in a specific space, saves money. Especially for seniors who have access to their homes and are devoid of paying any additional mortgage. In addition, providing a cleaner and hygienic environment to live in promotes better health and well-being.

Value-based Care Assists in Driving Valuation, Occupancy, and Better Outcomes for Senior Living

value-based care assisted living facilities

The shift in achieving better and greater clinical capabilities and providing seniors with better housing over the care continuum, has opened up opportunities for providers. They are partnering with primary care facilities, physician-led accountable care organizations (ACO), and Medicare-assisted approved living networks.

Ensuring participation in value-based care can drive better health outcomes for both residents and their families, providers, investors, and senior housing operators.

As it has been observed, the COVID-19 pandemic has already accelerated the boost towards value-based care and assisted living benefits for seniors. Providers who are arranging such system models into their operations will be able to switch to the pre-pandemic levels of occupancy, generation of leads, and net operating income.

With on-site clinical components, the readmittance of residents in communities after hospital or emergency room visits reduces the time constraints. This allows better bonding between care providers and residents and also enhances better home-based care services required.

There are several facility types and each offers different care services to the residents. Let’s have a look.

Facility types include:
  • Skilled Nursing Facilities
  • Nursing Homes
  • Assisted Living Residences
  • Adult Family Homes
  • Several Hospice Facilities
Types of services offered:
  • Skilled Nursing Care: It is not always offered to individuals seeking assisted living, and it requires Medicare licensure.
  • Occupational, physical, and speech therapy: These provide a better mental health service wherein seniors are encouraged to keep themselves occupied during their stay.
  • Dietary management: A dietary plan and management is planned and offered to the residents for better immunity.
  • Palliative and Hospice Care: It is not always offered to seniors, but palliative and hospice care can be provided at a senior’s residence. It offers better value-based care understanding and provides the services accordingly.

Steady Growth of Medicare Advantage Plans led by Senior Housing Operators and Providers

Nursing home care providers and other extended services are continuing to expand their Medicare Advantage benefaction in 2021. More operators and providers are looking towards gaining financial control towards Medicare senior living facilities and managed care services. According to ATI Advisory, there has been a steady growth in provider-led Institutional Special Needs Plans (I-SNPs) which increased from 76 in 2020, to 98 in 2021. This amounts to a complete representation of Medicare-approved assisted living and nursing home facilities to 37% in 2021 from just a mere 9% in 2015.

In April 2021, senior housing occupancy rates have steadily increased to 20 basis points. Senior housing occupancy cost rates were previously observed in 60 markets. Hence, after 12 months of consecutive declination, the housing sector is exhibiting steady signs of a rebound. Members can now have access to timely data, including the 3-month data rolling report on stabilized occupancy every month.

With assisted living aids, adult care communities, skilled nursing facilities (SNPs), independent living apartments, family-type homes, and more, these operators and providers are ensuring better living conditions for seniors. The steady growth in Medicare assisted living benefits led by the above-mentioned senior housing operators and providers are likely to provide better in-home and home-based care services.

Challenges of Housing for Senior Population

The older population is constantly in face of numerous challenges including affordability, physical accessibilities, and accessibility to other services like medical and non-medical services. Senior persons living in rural accommodations experience additional challenges related to isolation from relatives and neighbors, medical services, and other amenities. Some of the major challenges include:

  • Affordability and Cost of Living

    The percentage of older adults and the senior population who rent their spaces is seeing a steady growth from 21% in 2015 to 23% in 2035. Owners and housing providers face the challenge of adequate affordability. The mortgage debt has doubled over the years for those who are of 65-74 years of age.

  • Accessibility modifications

    With the rise in the senior population, there is an equal rise in people suffering from various disabilities, minorities, and people with low-income rates. These individuals require safe home-based care and assisted benefits for housing seniors to age comfortably in their homes. Accessibility can be a major challenge as these individuals will be affected by mobility issues, the ability to engage in self-care methods, and cannot complete basic household tasks. Furthermore, cases of dementia and Alzheimer’s will also increase even if the incidence rate falls.

  • Factors of Isolation

    As individuals begin to age, they lose their ability to drive from point A to point B. This results in them becoming socially isolated. They also experience difficulty in accessing health providers, medical and non-medical services, and community amenities and features. Scheduled activities such as grocery shopping, medical visits, and pharmacy visits become unaffordable and inadequate as people begin to age.

Medicare Housing Benefits Ensuring Enhanced Opportunities to Senior Housing Facilities

Facility-based care provided by SNFs (skilled nursing facilities) offers assisted living benefits and adult family homes to seniors residents. Although CMS has a set standard and regulation requirements for how long an individual can reside in the facility, and the services they will receive during their stay. This rule varies from state to state in the case of Medicaid, it is the same when it is a Medicare requirement to mitigate homelessness for Medicare members. The benefits of assisted living are as follows:

  • 24-hour care provided by healthcare professionals and providers.
  • It includes comprehensive care services.
  • Provides a secure and safe living environment for seniors, minorities, people with low wages, and chronically ill individuals.
  • Facilities that are run tribally, offer culturally competent care to the residents.
  • If the facility is licensed by Medicare, the services are open to non-American Indians (AI) and Alaska Natives (ANs) as well. This ensures quality care for the non-Indian community members and increased income for the program.

The key takeaways of Medicare housing benefits also include:

  • Enrollment in MA plans has been steadily increasing, which is opening the health market to implement new approaches and plans.
  • Care coordination is becoming an effective and valuable asset to payers, that recompensate for care settings and focuses more on qualitative care over quantitative services.
  • Solving logistical challenges for providers and seniors in better access to care.
Value-based healthcare is helping to determine and document risk adjustment profiles offering better care delivery

Wrapping Up,

Rainbow Health’s extensive supplemental benefits for the chronically and senior care offer an array of services that can help manifest better health outcomes. With intensive integration of home-based care services and compliance with Medicare regulations, care delivery will soon experience a revolutionary transformation. With assisted living benefits and Medicare Advantage plans to provide housing benefits to seniors improving health outcomes. Rainbow Health can truly transform Medicare-approved assisted living towards a better future.

For payers, providers, and other healthcare organizations looking to implement assisted living benefits for seniors into their existing system, Rainbow Health’s integrated platform promises to address both chronicle and social needs of patients. Our community resource and supplemental benefit platform ensures high-quality care coordination, improves member experience, collaborates with care teams, and provides better provider-provider interactions. Last-mile care delivery, logistics of ancillary benefits, and community-based resources, and optimizing mobility of providers to offer care to seniors where they need it when they need it. Therefore, improving better health outcomes at social and healthcare levels.

Implement a hassle-free care coordination platform into your system for better senior assisted living with Rainbow Health

Author's Bio

Ayushi Patel Mobisoft Infotech

Ayushi Patel

Ayushi Patel is the Director of Strategy & Innovation at Mobisoft Infotech. She leads the strategic partnerships and initiatives in the healthcare division. Her experience includes healthcare administration, business development and sales, and customer success management.