Integrated Healthcare in Housing for Elderly Lowered Inpatient Stays, Readmissions

An innovative housing model for seniors that incorporates healthcare within the residential environment contributed to lowered rates of both inpatient hospitalizations and readmissions, according to a recent study.

The model, called Connect4Life, was developed by Juniper Communities, which operates a number of residential living facilities for the elderly. Connect4Life’s central aim is to fully integrate healthcare, including comprehensive therapy and pharmacy and laboratory services, into the living environment. The model’s “high-tech, high-touch” approach to this integration is evidenced by both the use of electronic health records to manage patients’ medical information and the availability of patient navigators to provide support and care coordination.

An analysis compared outcomes for residents in the Connect4Life program and similarly frail people living in the community or in senior housing that does not employ an integrated care model. Using data from the 2012 Medicare Beneficiaries Survey, researchers identified a comparison group that consisted of elderly people who received help with at least 1 activity of daily living or was experiencing cognitive impairment.

The Juniper patient group was, on average, older and more likely to be cognitively impaired, but still demonstrated 50% lower rates of inpatient hospitalization and 80% lower readmission rates compared with the non-integrated comparison group. Their emergency department utilization was 15% lower than that of the comparison group.

High-needs patients, who have multiple chronic conditions and complex social needs but cannot live independently, are a significant driver of Medicare costs. According to the report, spending on the population defined as similarly frail in this study averaged $18,377 per capita, more than double the average spending for all Medicare beneficiaries.

The study noted that keeping these patients out of the hospital not only avoided additional spending, but helped achieve the 2 other components of the Triple Aim: improving care and improving customer satisfaction.

“The data suggest that integrating clinical care with the supportive environment and services provided by licensed seniors housing may dramatically reduce utilization of high-cost services which also have been shown to disrupt quality of life and impact the long-term wellbeing, particularly of frail, chronically ill seniors,” the report stated.

According to researcher Anne Tumlinson, the study showed that integrated care is a viable solution for residential facilities looking to decrease unnecessary spending while improving health outcomes and quality of life among their patients.

“The findings clearly suggest that integrated seniors housing services programs like Juniper Communities’ Connect4Life have great potential to reduce the cost of care to high-need, high-cost Medicare beneficiaries,” said Tumlinson in a press statement. “This is incredibly important news for accountable care and managed care organizations who should be working with innovative seniors housing providers to manage population health. Juniper's Connect4Life model appears able to outperform fee-for-service Medicare for similarly frail beneficiaries living in the community or other seniors housing."