Providers See Growth in Continuing Care at Home Models

As older adults continue to live much longer, healthier lives, senior living options for aging in place become more and more attractive—among them the concept of continuing care retirement communities (CCRCs) “without walls,” or continuing care at home (CCaH) models.

These programs allows healthy, active older adults to maintain their independence at home, but also enables them to make arrangements for long-term care in the event of a change in their acuity.

Typical plans require members to be healthy upon enrollment and pay various fees, often including an entrance fee. Members also pay into the program on a regular basis in exchange for a range of care services, including care coordination, non-medical home care, emergency response and coordination of Medicare services, among others. Should a change in the individual’s health or independence occur, access to an assisted living community is an option, according to Washington, D.C.-based senior care industry association LeadingAge.

Care coordination

The CCaH model was first developed in the 1980s, and since then, more than 30 similar models have sprouted across the country, according to Carol Barbour, president of Plymouth, Pennsylvania-based Friends LifeCare, a senior care provider that offers a range of long-term care solutions, including home health care, personal-care services and facility care to enrolled members.

Barbour has been with the company for more than 30 years and played an instrumental role in developing the company’s CCaH model—the first ever in the country—which was established in 1987. The company has seen enrollment in its CCaH increase to 2,500 people.

For Barbour, the aspect of care coordination has really been the model’s selling point, touting it as the individual’s “safety net” as they age.

“It’s the role of the care coordinator not just to coordinate services such as non-medical home care … but it’s also important [for them] to be [the client’s] advocate and coordinate all the services they might need should they have a change in health,” Barbour told HHCN.

This concept has senior care providers realizing its benefits, as some have begun to enter themselves into the CCaH arena.

Alexandria, Virginia-based Goodwin House operates two senior living communities in the city, offering residential and assisted living, memory care, skilled nursing, palliative care and hospice. The company also offers home care through its Goodwin House at Home model, which it launched in June 2014.

Like Barbour, Karen Skeens, executive director of Goodwin House at Home, acknowledged the role that care coordination plays in improving the quality of life of the client. The company’s care coordinators partner with home care agencies and work with therapists, and even hospital discharge planners, as part of its CCaH model.

“The thing about the continuing care at home program is that we are not reinventing, per se, any of the services. What we have done is really packaged all of those services into a comprehensive program that has that care coordination,” Skeens told HHCN.

Members receiving care at home also have the option to move into one of Goodwin’s communities in Alexandria, should a change in their health or care needs occur. Like other CCaH models, Goodwin House at Home operates as a membership-based program, which is structured similarly to its life plan models implemented in their communities, explained Skeens.

“We set aside the membership fee to be able to make sure that we are able to pay for the individual’s care when they need it, so the individual is paying for future care,” said Skeens. “This is a new business line, and so we expect, as we build this program, to be really self-sustaining from a revenue standpoint.”

Factors such as a person’s age, the extent of their coverage, as well as the years/duration of care they need, affect the overall cost of membership, according to FriendsLife Care’s “Membership Benefits Calculator.”

On average, the fee for being enrolled in FriendsLife Care’s CCaH program is approximately $3,000 per year, which covers the cost of services up to the daily and lifetime limits individuals select upon enrollment, according to Barbour.

CCaH’s evolution

Barbour and her team have been working to expand FriendsLife Care’s reach.

The company recently entered into a partnership with Nazareth, Pennsylvania-based Morningstar Living, a senior living operator offering retirement and life plan communities and home care across Nazareth and Allentown, Pennsylvania. The goal behind the partnership was to not only expand FriendsLife Care’s footprint in the region, but to also provide their brand of long-term home care to a growing client base.

“It has enabled Friends LifeCare to expand our geographic territory up into the Lehigh Valley where Morningstar operates,” said Barbour.

Though the partnership with Morningstar is only a month old, both companies have been able to collaborate in various ways, according to Barbour.

“Part of the Morningstar Living organization [is their] home care agency, Morningstar Senior Solutions, so they are the preferred provider of home care services if any of the members of our program … need that medical home care,” said Barbour.

Goodwin continues to fine-tune its model and conducts yearly health assessments with patients to ensure they’re receiving the highest-quality care they need, explained Skeens.

“We’re base-lining from year to year on those health assessments, and if we start to see a change, our care coordination team can start to come up with suggestions on things that we may suggest to put into place to help that individual continue to be independent in their home before it ever gets to a crisis situation,” said Skeens.

Barbour and her team also rely on regular satisfaction surveys with members to ensure the effectiveness of their CCaH program. What she finds exciting about the model is the overall growth it has seen both locally, and as other organization’s pursue the model in other markets.

Barbour added that she and her team are providing consultation to other senior care organizations to develop their own CCaH models.

“We think there are other opportunities for different types of partnerships in different areas. So, I do think that growth through collaboration and partnerships is very much a part of our future,” said Barbour.

Written by Carlo Calma