Senior Housing News “Utah’s First Life Plan Community to be ‘Lab’ for Health System Relationship”

June 5, 2018 by Tim Regan for Senior Housing News

When Summit Vista opens this fall, it will mark the arrival of Utah’s first entrance-deposit life plan community—and illustrate the growing trend of collaboration between senior living providers and health systems.

All told, the roughly $400 million community is planned to occupy 100 acres in the city of Taylorsville, and is entitled for up to 1,600 independent living units and 300 beds for assisted living, memory care, nursing care and short-term rehab. Amenities in the works include a 62,000-square-foot clubhouse, three restaurants, a marketplace and cafe, lap pool, fitness center, classroom and arts studio, beauty salon and spa, billiards and games room and outdoor recreational options.

But perhaps the community’s most innovative perk is its relationship with Intermountain Healthcare, a Utah-based health system that has 22 hospitals, more than 180 clinics and its own health insurance plan.

The topic of senior living integration with health systems has been much discussed lately, sparked by recent developments. These include the move by Toledo, Ohio-based health system ProMedica to acquire skilled nursing and home health giant HCR ManorCare, in a deal involving real estate investment trust (REIT) Welltower Inc. (NYSE: WELL). In addition, a recent Medicare Advantage rule change could bring MA reimbursement into assisted living, which could further incentivize tie-ups between senior living providers and health systems that also offer their own insurance plans.

While the scope of the Intermountain relationship with Summit Vista is far smaller than ProMedica’s ManorCare play, it offers another look at how senior living and health systems are starting to work together more closely.

“Intermountain is one of most progressive and innovative health systems in the U.S.,” Mark Erickson, Summit Vista’s CEO and executive director, told Senior Housing News. “It was natural to go talk to them.”

Work will wrap up in phases, with the community’s first residential building due to welcome more than 110 residents this fall. Summit Vista also broke ground on its second residential building, Maple Point, in May, and plans to open that building in July, 2019. Des Moines, Iowa-based Life Care Services, an LCS company, will manage and operate the community. Financial backing for Summit Vista comes from investors including Gardner Company, iStar and Solamere Capital.

Health care connection

Summit Vista first approached Intermountain to talk about its vision of linking up with the health care system in 2016. The senior living company saw Intermountain as a health system focused on reducing costs by increasing quality, keeping people healthy, managing patients with chronic diseases and streamlining care—all shared goals, Erickson said.

“When we came and said, here’s our vision … would you like to work with us to provide care services and use this as a little laboratory? And they said it was exciting,” he recalled.

Under the relationship, Summit Vista’s residents will be able to see Intermountain’s primary care physicians at a primary care clinic in the same community where they live—at least, that’s the eventual goal. Initially, residents will be able to utilize an Intermountain clinic about two miles from the campus.

The idea is that residents will be able to see a physician as soon as problems arise, and not have to wait and risk developing a more serious and oftentimes more costly condition.

“One of the things Intermountain has been focused on is population health, health and wellness, preventative care, and getting out in front of disease and disability,” Erickson said. “If someone has a cough, they don’t have to wait until they have bronchitis.”

Summit Vista’s collaboration with the health system will also help with chronic disease management and coordinated specialty care, and give residents access to more ancillary services, Intermountain’s Select Health Medicare Advantage plan, and the health system’s signature health and wellness services.

In turn, Intermountain can use the relationship as an opportunity for innovation and collaboration, according to Rebekah Couper-Noles, associate chief nursing officer with Intermountain.

“We’re all pretty accustomed to a model where we have hospitals, we have clinics, and we provide services at those locations, but are we really doing the best for the health of the whole community?” Couper-Noles told SHN. “We really need to think about how to make it easy to access care across the continuum, how to make those access points [make sense] for residents, and do it in a way that we could potentially model and collaborate with others.”

Intermountain will initially evaluate the quality, experience and the cost of care it delivers as some primary benchmarks of success.

“Those domains are incredibly connected, and our goal is to move the mark in all three of those areas,” Couper-Noles said. “What is the experience, what are some of the outcomes, and what services are being utilized will probably be some of our initial areas to see how this is working as a product and a service offering.”

Intermountain’s inroads

Collaborating with a life plan community isn’t the only way Intermountain is making inroads into the senior care space.

In May, Intermountain announced a partnership with Minnesota-based Lifesprk to jointly launch Homespire, a new private-duty home care model for Utah’s rapidly aging population. Among Homespire’s goals are cutting health care costs and rehospitalization rates, and preventing emergency room visits.

No doubt, demographics play a role in the health system’s decision to link up with senior care providers. Utah’s 65-and-older population could double in size in the next 50 years, according to data from the University of Utah’s Kem C. Gardner Policy Institute. In 2015, people between the ages of 65 and 85 made up about 10% of the state’s population, but by 2065, they could account for as much as one-fifth of it.

Elsewhere in the U.S., health systems and managed care organizations are increasingly seeing the value in linking up with, or outright owning, senior living and skilled nursing providers.

Perhaps the biggest sign of things to come is the recent $1.95 billion acquisition agreeement between Welltower Inc. (NYSE: WELL), Quality Care Properties (NYSE: QCP), HCR ManorCare and ProMedica. Though the deal is complex, it essentially brings the vast network of HCR ManorCare skilled nursing facilities, senior living communities, and home health and hospice locations under the umbrella of ProMedica, marking the first time that a health system and insurer has direct operational control over such a vast senior care and post-acute platform.

Some believe that other health systems could follow ProMedica’s lead, and acquire senior living and care companies to help manage the health of their patient and/or insurance beneficiary populations. Intermountain did not elaborate on the possibility of an outright acquisition of this sort being made by the health system, but did endorse the general argument in favor of integration.

“I think that it makes sense because many organizations are looking at cost trends and understanding that there is a lot of high-dollar spend at the end of a member or community’s lifespan, and there is an ability to impact that,” Couper-Noles said. “If we think about what is the right thing for most patients or families, the right thing is to move the care to the setting they prefer, and for most people, that is not in an acute setting.”

Written by Tim Regan