Traditional continuing care retirement communities are looking for business opportunities to expand into home care. One option is a Continuing Care at Home program.
Sometimes called Lifecare at Home or continuing care retirement communities (CCRCs) without walls, Continuing Care at Home (CCaH) offers care similar to what residents would get in a CCRC facility but in the home setting, explained Susan Hawkins, executive director of Cadbury Consulting, during an Irving Levin Associates webinar on the topic. Hawkins helped to create one of the first CCaH programs, Cadbury at Home, in the country, launched in 1998.
It is an option for healthy, independent seniors who want to stay in their own homes with a long-term care plan in place that incorporates a personal care coordinator that will provide and coordinate care and appropriate services when needed, as well as offer access to the activities, amenities and social programs that are associated with living in a CCRC, Hawkins said.
To participate in a CCaH program, members pay an initial member fee similar to a CCRC entrance fee and then pay a monthly maintenance fee. The fees are usually based on the age of the person enrolling. Some operators of CCaHs also offer a variety of plan options, from the all-inclusive plans which provide 100 percent coverage of care coordination services, health support services, assisted living care, nursing home care and lifestyle and wellness programs to lesser degrees of those services. There are also options for couples in the situation where one qualifies for CCaH participation, but the other doesn’t.
“It seems as if today’s environment is ripe for those types of new programs that don’t require borrowing money to be able to expand service options and to be able to reach out to that aging population that want to stay in their homes and may not consider coming into a community, and at the same time, it’s creating new revenue sources for the organization, new markets and new efficiencies within that, and in the end, is a great way and a great opportunity to expand the mission as well,” she said.
With land-locked campuses in New Jersey, Cadbury needed to find ways to expand its reach without having to physically expand, said Victor Amey, president and CEO of Cadbury Senior Services. Cadbury dipped its toe into the CCaH world by offering the program in two counties in New Jersey. Today, the CCaH program services seven counties in southern New Jersey and has expanded into southern Delaware.
“We think this really offers an opportunity to serve people that you may not be able to serve on your campuses,” he said.
In addition to being able to expand geographic reach, start-up costs are low because no buildings are being purchased or built, he said. Most of the initial costs are in staffing and marketing and advertising expenses.
There is also the revenue-generating opportunity of being able to move CCaH members into the company’s associated nursing homes when, or if, the time comes, he noted.
No business expansion comes without some challenges, though, and one of CCaH’s is the time it takes to build interest, said Julia Portale, vice president of community services at Jewish Senior Services. The Connecticut-based nonprofit began implementing its CCaH by partnering with Cadbury in 2010.
Portale said taking the time to build relationships and understand the community is important. A CCaH program is of most interest to people who have the means to participate in the program and want the security of having their long-term care needs covered, she said. The people you are pitching the CCaH to may see the benefits and value of the program, but may need multiple points of contact over a period of time before they sign on.
Another challenge is the risk of the program, said Dan Gray, president of Continuum Development Services.
Gray pointed out that CCaH is still fairly new and only one program so far has reached significant size – most seem to reach a ceiling in the 200 to 300 member range. But growing membership beyond that threshold is vital to the model, he said, because the more healthy members there are in the program, the more affordable the pricing is and the broader the market – and the opportunity – becomes.
Gray noted that as the program matures, there will be greater understanding as to how to market the program and how to price it. However, he cautioned, companies that want in on this business opportunity shouldn’t wait until the market matures.
“This is a program that being the first in the market will be a key strategy,” he said. “This is not a ‘I’m going to replicate it and launch this late in my market after there’s already five organizations doing it’ (strategy) … If you want to develop this program, you need to begin early and help to figure it out and bring the first one to your market.”