OPERATIONAL EXCELLENCE


Opening Windows for Opportunities in Health Care


By Sara Wildberger


reasons our joints aren’t: They’re aging. Medicare is in its 50s, and despite some


C


changes 30 years ago, its strongly siloed system isn’t equipped to handle today’s re- alities. We’re living longer, facing multiple chronic conditions, and have complex and diverse fi nancial scenarios. And ahead are generations demanding individualized and customized services. “The stark reality is, people are aging in


a country where most delivery systems were built for healthy young people,” said Bruce Chernof, MD, FACP. “The good news is, we’ve come a long way. The bad news is, our models haven’t kept up.” Dr. Chernof is president and CEO of The


SCAN Foundation, which for more than a decade has supported “the creation of a more coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence.” In a recent interview, Chernoff talked


about big-picture challenges facing health care and senior living sectors alike—and how to establish some points of contact to transform both for better quality of life.


We’re in it together “The reality dawning on people is that the model that is the most expensive, with the least dignity, is the driving model that operates today,” Chernof said. And that’s not working from the human or the economic perspective. A centerpiece achievement of The


SCAN Foundation was the passage of The CHRONIC Care Act of 2018 (it stands for “Creating High-Quality Results and Out- comes Necessary to Improve Chronic Care,” and is part of the Bipartisan Budget Act).


40 SENIOR LIVING EXECUTIVE SEPTEMBER/OCTOBER 2018


onsider this: The systems around senior health care aren’t working as smoothly these days for the same


The CHRONIC Act is proof that there’s


agreement that existing solutions are neither cost-eff ective nor high-quality. The CHRONIC Act gives fl exibility to


cover non-medical needs, recognizes the realities of multiple chronic conditions and protects programs, and pushes Medi- care-Medicaid integration. Many of the provisions are around home care, but there are opportunities for senior living commu- nities as well.


Walled cities and windows of opportunity Chernof uses the “walled city” analogy to describe the current positions of both health care and residences for seniors. Both have highly regulated environments with specifi c funding streams. “This is fi ne if you’re inside the walls—


but if you need something on the other side, you’re faced with a whole new set of questions,” he said. The CHRONIC Act creates methods


for medical systems to take down their walls, through positioning a tailored set of community services as part of the Medicare benefi t, for example.


Change Agent Profi le


Bruce Chernof MD, FACP President & CEO, The SCAN Foundation


Looping in community services creates opportunities. For instance, a senior living community may lack windows and doors to the wider community. How can a communi- ty open these—to employees working in the community, for instance, or medical providers, or those providing food and other services?


At the nexus of housing and health The most important windows may be those through which the senior living and the health care sectors see each other. “This readership holds the key to how


people live,” Chernof says, “and how and where you live has a lot to do with how you defi ne yourself. ”


IMPACT OF MULTIPLE CHRONIC CONDITIONS


• Three in four Americans older than 65 live with multiple chronic conditions. • Medicare benefi ciaries with four or more chronic conditions account for 90 percent of Medicare hospital readmissions and 74 percent of overall Medicare spending.


• With an estimated doubling of the number of older Americans by 2050, the rapid change in demographics will place signifi cant strain on the nation’s health care system.


Source: Bipartisan Policy Center, Improving Care and Lowering Costs for Chronic Care Benefi ciaries: Implementing the Bipartisan Budget Act; based on Centers for Disease Control and Prevention data.


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