United Church Homes (UCH), which provides a range of care and services to older adults in skilled nursing centers and other settings, is making a value-based care play that involves health plan provider CareSource.
Ohio-based UCH and Metta Healthcare, the parent company of Ohio’s Hospice and Pure Healthcare, are forming a new nonprofit entity called Radiant Alliance, the organizations announced Friday.
The plan is for the new entity to become an affiliate of Dayton, Ohio-based CareSource. Through the alignment, the organizations will have “new opportunities to build and deploy integrated value-based care arrangements for high-acuity populations,” according to an announcement.
“We’re bringing our prior experience in bundled payment and reforms on the Medicare side and the skilled care side and how to integrate care management in order to moderate the cost, eliminate hospital transfers and unnecessary emergency room visits as well as premature nursing home transfers,” United Church Homes CEO Dr. Kenneth Daniel told Skilled Nursing News.
The organization, which has 102 owned and managed market-rate and affordable senior housing communities in 15 states, would remain “its own separate, legal entity” and be a partner with CareSource within the umbrella of CareSource subsidiaries.
“Now, we have access to the resources that CareSource can bring,” Daniel said. “We have access to capital, to technology and to the expertise of CareSource that will help us grow mutually in our collaborative efforts as well as individually.”
For example, United Church Homes and CareSource are considering how they can work together through CareSource’s D-SNP model, which provides Medicare Advantage benefits for people who are dually eligible for Medicare and Medicaid, Daniel said. The idea is to potentially enable residents of United Church Homes’ affordable housing communities to access more coordinated care, enhancing their wellness over time and reducing costs to the system by preventing costly interventions and transfers to higher levels of care.
The nonprofits partnered with CareSource have launched several pilot programs that will measure health outcomes, wellness, quality of life and ultimately, cost. Already they “are beginning to show significant value, especially for those with complex needs,” the partnership announcement noted.
When Daniel joined United Church Homes about 12 years ago, the organization owned or managed roughly 1,200 nursing home beds. In recent years, the nonprofit has made a concerted effort to reduce its skilled nursing center beds while diversifying the overall portfolio, and today has about half as many skilled beds compared to the start of Daniel’s tenure. In this regard, UCH is part of a larger trend, as nonprofits have divested of skilled nursing amid mounting financial losses.
The partnership with CareSource — which also provides managed Medicaid plans — is one way to continue to serve this part of the market, in Daniel’s view.
“We don’t need to only solely be involved with people and Medicaid when they need it at the end of life or the last phase of their lives in a nursing home,” he said. “So now we’re going to serve more people qualified for Medicaid in their homes and apartments in affordable housing. And it’s a far bigger impact ultimately, we think then we could just have limited to skilled nursing and custodial care.”
United Church Homes is gaining access to new resources through the partnership, including technology to aid operations, data management, efficiencies in purchasing power and strategic planning. With the strength in numbers, CareSource will have a “much more impactful voice” when dealing with CMS and HUD going forward, Daniel added.
Through the partnership, Daniel said he envisions opportunities to deploy capital more quickly, rather than waiting on public HUD funding. That will, in theory, allow the organization to reach more prospective residents of senior living faster.
UCH is also working with new technology companies identified by CareSource to monitor vital signs of older adults via wearable devices, as well as partnering with Ohio Hospice on a data center for UCH’s NaviGuide program, which pairs service coordinators with older adults to receive information and services from home care agencies to meal delivery, home maintenance and more.
“We want to integrate our data streams now into their systems and begin to get deeper understandings of all the clients,” Daniel said.
Daniel said he views the Radiant Alliance and the greater CareSource partnership as a sign of what’s to come in senior living and health care, as more operators and health care organizations pivot toward value-based care.
“We think there’s a tremendous opportunity to unlock those boundaries, coordinate reimbursement streams [and]build a model that’s more client focused and client directed that allows us through the leveraging of technology and data,” he said.
By helping to form Radiant Alliance, United Church Homes is joining a larger industry trend of skilled nursing and senior housing operators getting organized in anticipation of new payment frameworks. Indeed, American Health Care Association/National Center for Assisted Living CEO and President Mark Parkinson recently described the rise of value-based care as the “most exciting” development he’s seen in his 30-year career in the sector.
With contributions from Tim Mullaney
Companies featured in this article:
CareSource, Metta Healthcare, Ohio's Hospice, Pure Healthcare, United Church Homes
