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The new Bickford Senior Living Care models a “petri dish” for value-based care

Bickford Senior Living is all-in to push the industry further towards value-based care.

The Olathe, Kansas-based company has spent the past nine months building a new “Higher Path” care model that aims to coordinate various health services across its network of 60 communities in nine states, according to chairman Andy Eby.

Instead of only caring for residents when they are ill, Bickford’s management believes the industry has a huge opportunity to keep them healthy and, in the process, increase length of stay and quality of life.

“It’s about helping our seniors live happier, healthier and longer lives,” Eby told Senior Housing News. “It’s a much more proactive form of aged care and we’re very passionate about transforming that.”

Bickford is among some leaders within senior living in the race to deliver health care to seniors in new ways, including other providers who have been trying to find solutions through Medicare Advantage plans. Earlier this week, Eby told Senior Housing News he believed the $10 billion deal between Oak Street and CVS was a “critical stepping stone” to value-based care in the industry.

‘Petri dish’ for the rest

The push for value-based care in older people’s lives is already underway across the industry. In addition to Bickford, other providers are pioneering new ways for residents to pay for senior living, such as through a Medicare Advantage (MA) plan.

With his new model of care, Bickford is working on six main goals:

  • Develop coordination of primary care on site
  • Establish a high-performing care network in every community
  • Integration of the entire portfolio of results-based technologies
  • Structured weekly support team meetings known as “Higher Path Recommendations”
  • Unify health record keeping to better share data and improve outcomes
  • Build partnerships with value-based care-focused health plans

Nearly two-thirds of Bickford communities established at least part of the new care model in February, with a goal to have 100 percent of all communities “on some version” of the new care model by year’s end Eby said.

“We see ourselves as a petri dish of what we believe needs to emerge across the country regarding value-based care for this sector,” Eby said. “We are very active in implementing this model not only for us, but also for others who would have been considered previously [as] our competitors”.

Implementing the new care model requires “deep partnerships” with technology vendors, such as SafelyYou, an AI-enabled fall detection service; and local health systems.

Eby said that the industry as a whole has a great opportunity to create denser service networks through cooperation, to further push the industry towards value-based care. She gave the example of the Serviam Care Network, which has a similar goal to Bickford’s to more closely align the different moving parts of the aged living industry.

One reason some operators may not embrace the general shift to value-based care is that among all of today’s challenges – tight margins, staffing challenges, job recovery – they have enough to worry about.

But Eby said moving from a fee-based model to a value-based system would ultimately expand margins for aged care providers and help them access funding for better quality care.

As it stands, Eby said he believes suppliers are “stuck in the middle” by managing margins that are shrinking due to various external pressures, and it prevents operators from making innovative investments in technology.

“It’s about aligning healthcare providers to benefit financially from producing positive outcomes and that’s where our purpose and margin come together as one and are in conflict right now,” said Eby. “Our impetus for this model is to gain access to the savings we create through more proactive health care.”

This could lead to reinvestments among caregivers that will cause a “huge surge in technology solutions” within the lives of older adults, from improving health outcomes to extending length of stay.

In 2021, Bickford Senior Living launched Bickford Home Care in partnership with the HomeCare Advocacy Network (HCAN) to start a new line of services. The service is in part aimed at helping build relationships with prospective seniors before moving into a senior community.

“We don’t see the house as a competition with us,” Eby said. “We see it as a natural extension of care and we need to embrace the home and keep people in their homes for as long as possible.”

Having a well-functioning home care network is a “key part” of the success of the Higher Path model, Eby said, and the company has expanded into other markets since launching nearly two years ago.

This sea change in attitude from per-service to value-based support also comes amid significant shifts in the overall industry-wide pricing structure, as operators have pushed increases of between 7% and 13% to customers at record highs to offset the cost increase. This, coupled with high spending, has led to a need to balance margins and employment, Eby said.

“We’re keeping this balance between occupancy and margin and rates,” he said. “It’s a dance, a dynamic dance…and it takes a lot more complexity and an appreciation for local nuances and markets to get it right.”

In 2023, the company is slow to build and develop new communities, focusing instead on streamlining operations and building ancillary services like home care.

“Our number one goal is to run our branches on the Higher Path senior health model,” Eby said. “That requires an extraordinary amount of cooperation, deployment of technological resources.”

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