Bickford Senior Living is all-in on pushing the industry further toward value based care.

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

Instead of caring for residents only when they’re sick, Bickford management believes the industry has a huge opportunity to keep them well and in the process boost length of stay and quality of life.

“It’s all about helping our seniors live happier, healthier and longer lives,” Eby told Senior Housing News. “It’s a much more proactive form of senior 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 older adults in new ways, including other operators who have looked to find solutions through Medicare Advantage plans. Earlier this week, Eby told Senior Housing News he felt the $10 billion Oak Street and CVS deal was a “key stepping stone” for value-based care in the industry.

‘Petri dish’ for change

The push for value-based care in senior living is already underway across the industry. In addition to Bickford, other operators are experimenting with new ways for residents to pay for senior living, such as through a Medicare Advantage (MA) plan.

With its new care model, Bickford is working toward six main goals:

1. Developing on-site primary care coordination

2. Establishing a high-performing care network at each community

3. Integrating outcome-based technology portfolio-wide

4. Structured weekly care team meetings known as “Higher Path Councils”

5. Unifying health care recordkeeping to better share data to improve outcomes

6. Building partnerships with value based care-focused health plans

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

“We see ourselves as like a petri dish of what we believe needs to emerge throughout the country as far as stepping into value-based care for this industry,” Eby said. “We’re very active in implementing this model not only for us, but others that would have previously been considered [as] our competitors.”

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

Eby said the industry as a whole has a big opportunity to create densercare networks through cooperation, to further push the industry toward value-based care. He gave the example of the Serviam Care Network, which has a similar aim as Bickford of more closely aligning the senior living industry’s different moving parts.

One reason that some operators might not embrace the overall shift to value-based care is that among all of the challenges of today — depressed margins, staffing challenges, occupancy recovery — they have enough to worry about.

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

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

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

That could lead to reinvestment among operators that will cause a “huge wave of technological solutions” within senior living, 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 jumpstart a new service line. The service is in part aimed at helping to build relationships with prospective older adults prior to moving into a senior living community.

“We don’t see the home as 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 as long as possible.”

Having a high-functioning home care network is a “critical part” of the Higher Path model’s success, Eby said, and the company’s expanded to additional markets since the launch nearly two years ago.

This sea change in attitude from fee-for-service to value-based care also takes place amid significant change to the industry’s overall rate structure, as operators have pushed increases between 7% and 13% through to customers at record levels to offset rising costs. That, coupled with high expenses, have led to needing to balance for margins and occupancy, Eby said.

“We’re holding this balance between occupancy and margin and rates,” he said. “It’s a dance, a dynamic dance…and takes a lot more complexity and appreciation for nuance and local markets to set that right.”

In 2023, the company is slow to build and develop new communities, with the focus instead on optimizing operations and building out ancillary services like home care.

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

Austin Montgomery