Healthcare and housing programs designed for seniors were created in the early part of the 20th Century at a time when someone who was 65 could expect to live just another few years. Today, in an era when a 65 year old can expect to live 18 additional years, those same programs have not been adapted to address the huge and growing gap in vital services for seniors. Additionally, public policy and funding strategies fall short and do not reflect the new realities we face as a nation with a significant aging population.


There is no doubt that the current state of funding methodologies for health care and housing programs in this country will bankrupt society over the coming fifty years and/or services for seniors will deteriorate to a deplorable level where only the wealthiest families will have viable options. While the precarious future of Social Security has gained a considerable amount of attention, the real “ticking time bomb” is the Medicare and Medicaid programs. The number of people 65 and older is projected to more than double by 2050, while the number aged 90 and older will grow by 500 percent. Unfortunately, there has been little discussion or understanding of the fatal design flaws of the Medicare and Medicaid systems.


The approach to meeting the health care needs of the aging in this country is episodic and crisis oriented, not proactive, coordinated and holistic. The system is based on passive reactions to problems and mandates interventions at the highest cost, rather than adopting a lower cost, proactive pursuit of avoidance. There needs to be an aggressive, comprehensive search for significantly different funding and management approaches to the delivery of healthcare, and to meeting the lifelong residential housing needs among the aging population.


In response to the need for a model that ensures lifetime housing and healthcare security for seniors, Wesley Enhanced Living has developed WELShift, a new approach based on a continuing care retirement community (CCRC) setting. It offers a much broader spectrum of services and projects better outcomes and significantly lower costs. WELSHIFT manages and coordinates all aspects of their clients’ care and housing needs.


The WELShift community would be responsible for providing and/or coordinating and paying for all medical and housing needs for the residents in their community including: hospitalization, physician services, skilled nursing and therapy, assisted living services, home health, room and board (amenities will vary based on payments), and prescription drugs. This allows the CCRC provider to respond to its residents’ needs with the maximum flexibility and in the least restrictive, and least costly, environment. The provider would have the flexibility to use the combined private, Medicare and Medicaid funding in whatever ways will produce the best result for the senior. The coordinated, comprehensive, real-time service delivery approach this enables is not achievable in any other model and offers the only true opportunity to avoid a first hospitalization or avoid or delay the onset of chronic conditions.


Ultimately, in this type of proposed structure, everyone’s incentives are aligned to find the most cost effective and comprehensive package of services. Providers will have a strong incentive to enhance the outcomes for their residents, who, in turn, will demand more affordable options, as well as healthier and more purposeful senior years.


Jeff A. Petty is the architect of WELShift, and the president and CEO of Wesley Enhanced Living, a leader in the aging services field. To learn more go to About WELShift...