The Future of Continuing Care at Home Programs

by | Sep 8, 2021

Guest article by Lisa Hoffman, Executive Director, Pathstones by Phoebe; and Amanda Young, Director, BeWell @ Home 

The United States has a greater number of individuals older than 65 years old than ever before, with the fastest-growing segment being the 85-and-older population. The senior living field needs to find new, creative ways to meet the needs of this expansive market.

Most of these older adults prefer to age in place in their own homes. According to AARP’s “Home and Community Preferences Survey,” conducted by NORC at the University of Chicago, more than three in four people—77 percent—agree with the statement, “I’d really like to remain in my community for as long as possible.” Nearly the same number hope to stay in their current house. But only about half of adults 50-plus think they will be able to stay at home long term. “We know that most people want to stay in their own homes, and the fact that many won’t be able to says that we need to do more to ensure that people age the way they want to,” says Joanne Binette, senior research adviser for AARP policy research and international affairs.

For many people, COVID-19 has increased their concerns about moving into a senior living community at any level of care, thus also increasing their desire to stay at home. This concern about moving, paired with the sheer number of baby boomers now in their late 60s and 70s, means that now could be the time for continuing care at home (CCaH) programs to take their place as a full-fledged option in the long-term care continuum. A CCaH program enables Life Plan Communities to expand their mission by better meeting market needs.

The first CCaH program was started a little more than 30 years ago as an innovative and affordable alternative to living in a traditional continuing care retirement community. However, more than 30 years after the first program was started, there are still fewer than 40 programs across the entire country.

Mission-based organizations have not yet fully embraced the CCaH model for many possible reasons. Some viewed it as competition to their brick-and-mortar offerings, while others weren’t comfortable with the type of contract being offered, or were unsure how to deliver services off campus. As the director of a CCaH program who has seen firsthand the positive impact the program has had on clients and our parent organization, I’d like to share my thoughts on why I believe CCaH deserves strong consideration by many more communities.

Population aging, defined as increased longevity and decreased fertility rates, is already having an impact on the senior living field. Brick-and-mortar Life Plan Communities continue to see an increased age upon admission to their independent living, which is typically around 80 to 83 depending on the community. By comparison, most CCaH programs have an average age of admission of 73.

If Life Plan Communities continue to see an average age of admission in the early and mid-80s, CCaH programs appear to be an excellent opportunity to reach the desired market a decade before they may even consider moving into a community. What CCaH operators are finding is that this age difference is disrupting one of the first assumptions of CCaH programs: that CCaH was designed for individuals who never want to move into a community. Many long-time CCaH members are reconsidering a permanent move to a community after a change in their life or health.

I believe that bridge programs, which allow members of a CCaH to transfer into the sponsoring community’s brick-and-mortar residences with a full or partial credit for fees paid, should be built into all CCaH programs. The organization also would benefit from a bridge program as the CCaH wellness coordination team will be able to recommend the appropriate level of care for that person to move into the community. This will reduce the potential of needing a quick transition into another level of care due to health issues not discovered during the admission process for independent living.

CCaH programs also offer a way to partner with active adult communities, reducing the need for senior living organizations to invest in and maintain costly apartments and cottages. Active adult communities are an attractive option for seniors that value an independent, wellness-centered environment focusing on lifestyle over healthcare. Active adult community residents are largely baby boomers, who today are 56 to 76 years of age and have a completely different outlook on retirement than their counterparts from previous generations. 

The CCaH model provides a compelling alternative to long-term care insurance. While long-term care insurance products have evolved over time and are recovering from a steep decline in sales more than a decade ago, a CCaH is a strong alternative that offers benefits no insurance has, including personalized and proactive wellness coordination. 

As many consumer research studies on CCaH have shown, consumers want to be able to call someone directly and get exactly what they need without having to enter some sort of complicated paperwork process. Baby boomers want to remain in control and have easy access to services they need.

This is exactly what CCaH programs offer and accomplish. Calling a wellness coordinator who you know can be like talking with a family member, which offers consumers the personalized experience missing from most other healthcare alternatives. In addition, recent data show a 50% decrease of the likelihood of a skilled nursing admission among CCaH members. CCaH doesn’t just pay for long-term care, as insurance does: It reduces the chance that someone will ever need long-term care.

In short, senior living organizations can use CCaH to capture a younger market, meet the need for an alternative to long-term care insurance, offer a way to reduce healthcare costs, and promote independence through proactive wellness coordination. Older adults are looking for a way to stay at home, and a CCaH program offers a solid solution.

For more articles covering senior housing trends and how providers must adapt to them to continue fulfilling their missions, click here.

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