There is a misconception that Brookdale Senior Living’s (NYSE: BKD) growing HealthPlus strategy is geared toward residents with more acute care needs.
With a portfolio of 652 communities, more than 520 which offer assisted living and memory care services, it’s not hard to see why that misconception exists. The company’s program, which in a nutshell tasks nurses with coordinating health care and other services for residents, does not provide “sick care,” according to Senior Vice President and Chief Nursing Officer Kim Elliott.
Instead, it is meant to help keep residents well for longer, which in effect actually prevents them from moving to a higher rung on the acuity ladder, according to Senior Vice President and Chief Nursing Officer Kim Elliott.
“It’s to take better care of the acuity we already have,” Elliott told Senior Housing News. “I think the term healthcare kind of kind of stumps people, because when they think about what healthcare is, they think hospitals.”
The program is also more than just keeping residents living in their current care settings for longer. As CEO Cindy Baier told SHN in March, HealthPlus is aimed at preparing for a time in the future when “virtually every senior will be on a Medicare Advantage plan.” And Medicare Advantage penetration rates have increased steadily in recent years.
Brookdale is in 2024 rapidly growing its HealthPlus program. As of earlier this year, the program was in about 50 communities, with plans to expand to 129 by the year’s end. In short, the program is becoming an even larger part of what Brookdale does with each passing year.
“We have been working all year on expansion of about 80 additional communities, so it is a very large expansion for us,” Elliott said. “
‘It is a major transformation’
Bringing HealthPlus into senior living communities is a big undertaking requiring changing many facets of senior living operations. When Brookdale brings a new community into the HealthPlus program, its leaders usually hire a registered nurse, train staffers on a new electronic health record system and implement new protocols based on the program’s parameters.
In short, onboarding a community into HealthPlus “recreates everything about that community,” Elliott said.
“We intentionally disrupt a senior living community and every single element of the way that it runs changes,” she added. “It is a major transformation, and there’s a lot of work.”
The program trains Brookdale caregivers how to spot changes in a resident’s overall health. The operator’s salespeople also get a new playbook for discussing the program with families.
Also crucial to the program’s success is technology, specifically the use of electronic health records to track and manage resident conditions. The company benchmarks the program in a dashboard with a variety of key performance indicators, Elliott said.
At the end of the day, all of this can manifest in different ways at the resident level. For example, one resident might enter a community having only seen a cardiologist in recent years. Through evaluation and analysis, the operator might determine that the resident needs other kinds of care, or to see other kinds of doctors.
Depending on their needs, residents may get wellness visits, immunizations, and health screenings through the program. Along the way, Brookdale keeps all parties – residents, their families, payers and physicians – in the loop to best coordinate care.
According to Brookdale, communities using HealthPlus have seen 78% fewer urgent care visits, 36% fewer hospitalizations for residents and 63% more completed annual resident wellness visits. Baier has also noted in the past that communities using it are faster to grow “profitability” than those not offering it.
“If you truly surround them with the right experience and the right collaboration, it’s a game-changer,” Elliott said.
And diligently tracking resident health outcomes and conditions has other benefits in the form of highlighting best practices and other patterns in operations.
“When the magic happens, how do we take and repeat that, and then … when you’re rolling something out, how do you set the stage for success?” she added.
The program also is well-liked by some of the company’s nurses, who enjoy using the many skills they honed in school and on other jobs to help meet resident health and wellness needs.
“They love working at the top of their license,” Elliott added. “If we can keep our nurses happy in the way that they are involved, that’s been a big win.”
All in service of value-based care
As both Baier and Elliott have noted, the company is doing all of this in an effort to position itself as a leader in senior living resident wellspan as the value-based care trend continues to gain steam.
According to an analysis from ATI Advisory, the national MA penetration is 50.2% in 2024, which is up from 47.9% in 2023. The Centers for Medicare & Medicaid Services (CMS) has also set a goal of having all traditional Medicare beneficiaries and the vast majority of Medicaid beneficiaries in accountable care relationships by 2030.
“When you look at value-based care, the possibilities are endless,” she said. “If you don’t get that foundation right and you don’t have the true elements of a program that will do it, then you’re just not set up for the future.”
For the average resident and their families, “value-based care is a difference between night and day,” she added. Under HealthPlus, Brookdale has negotiated a per-member, per-month plan for residents in qualified health plans.
“It’s hard to navigate a healthcare system where they’re bouncing back and forth between different specialists and doctors. In many cases, they’re not even seeing a PCP,” she said. “When you have a very fragmented health care experience, and somebody has six or more chronic conditions, how you manage that really takes a lot of coordination, collaboration and everybody has to do their part.”
Looking ahead, those trends mean HealthPlus will continue to be a big part of what Brookdale does. HealthPlus has also been an important differentiator in the operator’s value proposition to new residents.
“We’re prioritizing the markets and the communities where we feel like it can make the most impact,” Elliott said. “Whether it’s this or value based care, we’re going to continue to lean into how we completely embrace and change the way that our residents receive care.”
