WELShift In the News - Article Detail

 

A Continuing Care Retirement Community (CCRC) for the Middle Class – Part 2 12/5/2012 What this model might look like in real life . . .

by Steve Moran, SeniorHousingForum.net

 

In part one of this two part series, I outlined the rapidly expanding senior housing/healthcare crisis as described by Jeff Petty (a view I largely agree with). That was the set-up. This is the fun stuff: what this model might look like in real life.

 

Imagine having a conversation with your mom or dad about retirement and money (the number one concern of seniors), or maybe you are a boomer like me and you realize there are not so many years left until you hit that traditional retirement age of 65 and you know, you don’t have enough money to see you though the rest of your life in the senior housing community you work in or around.

 

SHIFT CCRC As It Could Be Today!

But there is hope, because you have heard about this newly opened SHIFT senior community that promises to make the “running out of money” problem go away. You are not real excited about moving into a community with a bunch of old folks, in fact your dream had always been to retire in your own home that is free and clear, but you are now realizing that dream may not be possible. You reluctantly decide to check it out.

 

You discover a campus that feels a bit like a college, but with individual apartments of varying sizes and prices. As you walk around you, realize that while there are some old and obviously frail seniors, there are also a lot more, people who look pretty much like you.

 

Digging deeper, you discover there is a physician, nurse practitioner, or physician’s assistant on campus 24/7. Even better, if you are sick or unable to get to the physician’s office, they will come visit you. They have more than just doctors; they have physical therapy, a small laboratory and an x-ray suite.

 

You still wonder what day-to-day life will be like. You discover there is so much more than Bingo, Birthdays and Bible Study. There are classes, and service clubs, golf outings, shopping trips, multi-day excursions. They even have 70’s and 80’s classic rock playing in the dining room.

 

Making the Dollars Work

Convinced you or your parent’s couldn’t possibly afford this; with great hesitation you ask the big question: 

“How much does it cost?”

 

They tell you it is affordable . . . that even if you still owe some money on your house and only have social security plus a tiny retirement plan that generates just a few hundred dollars a month, they can make it work for you. The community then goes on to explain that if you have something over $100,000 in equity, that you can use as a buy-in, you are well on your way. You then wonder about the monthly payment and they explain that if you and your wife are receiving maximum Social Security that will be enough.

 

Then you ask the other big question, what if I get really sick, how will I pay the out-of-pocket medical expenses? They explain, what you are getting is more than just housing, meal service and activities. The community will become your insurance company; they will become the payer of last resort. They will require you to assign your Medicare benefits to the community, just like you would for a traditional senior HMO, and that if you ultimately spend down the principal of your little pension plan, you will also assign your Medicaid benefits to the community. In return, the community will make sure you get home health if you need it, assisted living if you need it, memory care, skilled nursing, hospice and even acute hospital care hospitalization. The goal is to remove the uncertainty. The goal is to give you Mercedes care with a Yugo budget.

 

Why it does not exist today

It doesn’t exist today, because it does not fit neatly into today’s Medicare/Medicaid system. There is no mechanism for this hypothetical CCRC to be able to have Medicare/Medicaid payments assigned to the CCRC in return for going 100% at risk for housing, nourishment, wellness and healthcare. Jeff Petty has spent time and money having studies done that demonstrate a 20%-50% savings from the traditional model of providing housing and healthcare to seniors and yet to this point no one in the federal government is willing to stick their neck out and give it a try.

 

In the meantime the federal government has invested hundreds of millions in the great ACO experiment which to date, has demonstrated no meaningful cost savings and no improve in patient quality of life. The government has spent billions on the Medicare Advantage program and the most recent data suggests that rather than saving money it is costing the government more.

 

All Jeff is asking is for is a chance to do this as a demonstration project. Given the scope of the problem the cost is small and the potential benefit is huge. If you want details you can contact Jeff at: jpetty@wel.org