Few would expect nursing homes and assisted living operators to be able or willing to manage health care risk for some of the highest-cost Medicare beneficiaries. Yet, earlier this month, Senior Housing News announced the formation of the Perennial Consortium, a group of three senior housing operators and a managed services partner and risk management company, which will officially launch in 2021. The operators in this consortium are Christian Living Communities (Englewood, CO), Juniper Communities (Bloomfield, NJ) and Ohio Living (Columbus, OH) and they are joined by AllyAlign Health, a managed services partner from Glen Allen, VA. Once launched, the Consortium will first target Colorado and Ohio by making available Medicare Advantage (MA) special needs plans and selling ownership interest to the senior living operators in each state.

This new collaboration is part of a larger trend nationwide for nursing homes and assisted living providers to form Institutional Special Needs Plans (I-SNPs) to better serve the highest-cost Medicare beneficiaries while also taking on more healthcare risk as a way of creating a new and viable business revenue stream. In fact, long-term care providers now lead 21 of the 24 provider-led I-SNPS. This is a way for long-term care providers to move beyond their current reliance on revenue from volume and daily rates and instead grow their business based on savings from reduced hospitalizations, shorter stays, and coordinated care transitions.

The Perennial Consortium is a new and different approach because it sets up an I-SNP ready platform that checks the main boxes for provider-owned I-SNP readiness:

  • Optimize Enrollment Potential.

Having sufficient enrollment is a necessary component of successfully operating an I-SNP. The Consortium has brought together three senior care organizations, and their respective resident populations, so they are more than ready to supply the potential enrollment population necessary to spread healthcare risk. Together, the three organizations represent hundreds of thousands of lives. This means that any other organizations joining them in the states where they operate will have immediate access to this sizeable risk pool. We know from experience that many provider-led I-SNPs have been successful with as few as 350-500 enrollees. However, it’s better to have more enrollees, and establishing provider partnerships such as the Consortium guarantees just that.

  • Guarantee Efficiency.

Another success factor in forming and operating an I-SNP, as a provider, is the ability to manage healthcare risk and to deliver care efficiently. One of the Consortium members, Juniper Communities, brings a proven care model to the new Consortium. Juniper’s Connect4Life model integrates primary care and other ancillary services through a high-tech, high-touch care management platform. ATI analysis of Juniper’s electronic health records indicates that the rate of inpatient hospitalizations for the Juniper community is about half of a comparable population living in the community. Further, we found that, after implementation of Connect4Life, Juniper residents have been less likely to move on to nursing home level care.

  • Understand the Environment.

Any provider interested in forming and operating an I-SNP needs a solutions partner to help navigate the state regulatory environment, establish a provider network, and participate as a capital partner to meet reserve requirements. The Perennial Consortium is ready to handle market and environmental challenges through the expertise of its fourth partner, AllyAlign Health, which was founded in 2013 and currently has 19 provider-sponsored managed care plans in 16 states.

Anne Tumlinson will be presenting a keynote session about this topic in more depth at the 2019 LeadingAge Illinois Annual Meeting and Expo in Schaumburg, Illinois. If your company is interested in assessing your I-SNP readiness and learning about next steps, please contact: info@annetumlinson.com