Older adults benefit when health care providers and affordable housing sites partner, finds research

Older adults benefit from enhanced partnerships between health care systems and affordable housing sites. These partnerships improve health care outcomes while reducing unnecessary spending and/or use, according to research published in Health Services Research.

"The effect of the Right Care, Right Place, Right Time (R3) initiative on Medicare health service use among older affordable housing residents" study was designed to evaluate the R3 program of Hebrew SeniorLife, a Harvard Medical School-affiliated nonprofit. The report was coauthored by Tavares, J. Simpson, L. Miller, EA, Nadash, P. and Cohen, M. of the LeadingAge LTSS Center @UMass Boston.

Seniors living in sites with the R3 program had lower hospitalization rates, days, payments and readmissions than residents living in similar control sites. This is the first study to document a decline in 30-day re-hospitalization rates among low-income senior housing residents who have access to place-based wellness teams, when compared to low-income seniors in buildings without this level of support.

R3 embeds a wellness nurse and coordinator in senior housing. The place-based team efficiently conducts assessments and routine proactive check-in calls, risk stratifies the population based on established key risk factors, puts services in place to meet needs, partners with organizations to strengthen care coordination and communication, and tracks/trends data to drive and monitor results.

Hebrew SeniorLife developed R3 to address the disconnect between housing and health systems in order to improve the health and well-being of seniors. Partners, including emergency responders, health plans, area agencies on aging, and government agencies, were able to leverage congregate senior housing to achieve positive outcomes.

The research sought to determine the effect of this housing-based intervention on Medicare health service use among senior housing residents. R3 enrolled 400 participants across seven intervention sites, four operated by Hebrew SeniorLife and three operated by partner providers, including Milton Residences for the Elderly and WinnCompanies.

Program Impact

Researchers noted that "The findings suggest that the combined focus on assessment, proactive outreach, and prevention (with special attention to high-risk individuals); coordination with off-site providers; and the strengthening of an 'eyes-on' culture, led to the positive results."

"Both the comprehensive quantitative and qualitative analyses that we have undertaken demonstrate conclusively that the program is having a major and positive effect on residents and that health care payers also benefit from lower health care costs by having their members participate in the program," said Marc A. Cohen, Co-Director of the LeadingAge LTSS Center at UMass Boston. "The R3 program hits all success metrics."

"This research demonstrates that R3 delivers much-needed health and quality-of-life improvements for residents of senior housing," said Louis J. Woolf, president and CEO of Hebrew SeniorLife.

"At the same time, R3 contributes to efforts that avoid unnecessary care and reduce costs for a system that is beset with labor challenges and struggling to provide both sufficient and affordable services. We are encouraged by the fact that with this data, policy makers are giving serious consideration to the benefit of adopting R3-like programs across the Commonwealth."

Researchers concluded: "Age-friendly health systems would do well to enhance partnerships with affordable housing sites to improve care and reduce service use for older residents."