Tag Archive for: Anne Tumlinson

Portrait of smiling multi-generation family sitting

Caregiving Navigation Hubs: A Critical Resource for Older Adults and their Families

Coordinating caregiving for aging loved ones is a complicated and frustrating task for families. And the problem is growing.

According to a recent article in Next Avenue, “It generally starts with a crisis: Your parent shows signs of dementia…or is about to be discharged from a serious hospital stay…or requires help with daily activities of living. What do you do? Where do you turn? It’s the little-discussed part of long-term care that leaves many of the nation’s 22 million family caregivers for older loved ones bereft and befuddled.”

“We’re failing tens of thousands of older adults and their families,” said Bob Kramer, Founder and Fellow of Nexus Insights.

Nexus Insights is a think tank advancing the well-being of older adults through innovative models of housing, community and healthcare.

In early 2022, Nexus Insights brought together long-term care providers, caregiver advocates, tech-driven startups and policy experts in its first ‘Nexus Voices’ salon to discuss how to help older adults and their caregivers better navigate the complex and fragmented array of long-term care and aging services. The result was a report released in September 2022, “Where Am I, Where Do I Go: The Missing Entry Point to Long-Term Care Solutions for Older Adults and Their Caregivers.

This report was the subject of the Next Avenue article, written by Richard Eisenberg.

Eisenberg spoke to several of the report’s authors, including Anne Tumlinson, CEO of ATI Advisory and a Nexus Fellow. “The primary challenge that most of my peers and friends and family were experiencing was entering into that phase of their lives when they were suddenly thrust into family caregiving roles and feeling like there’s no place to go,” Tumlinson said. “In the best-case scenario they’re getting a hospital discharge planner handing them a long list of organizations who are like, ‘Good luck. Here you go.'”

Caroline Pearson, another report author concurred. Pearson, formerly the Senior VP of Health Care Strategy at NORC at the University of Chicago, and now the Executive Director for The Peterson Center on Healthcare, and a Nexus Fellow. “Unfortunately, most people find themselves in these urgent scenarios that are sort of a call for help unexpectedly,” she said.

In fact, Nexus recently partnered with NORC to conduct a survey on this issue. The survey showed that 1 in 4 older adults needed long-term care services for themselves or a loved one in just the previous 12 months. It also echoed the report’s assertion that caregivers experience frustration and anxiety during the process.

The Nexus Voices report offers a powerful solution, according to the article, “A national, independent, trusted hub system of caregiving navigators who would be accessible to everyone and serve as a central doorway to long-term care services and supports.”

“For every single family to be creating a long-term care service delivery system is very inefficient from a societal standpoint and an economy standpoint,” said Tumlinson.

The solution would have to be national in scope. “There was broad-based agreement [among the salon participants] that creating the kind of awareness to make these hubs as visible as your local drugstore or post office was going to take a national effort, and a level of funding that was probably going to have to be federally driven,” said Kramer.

According to the article, a local example of such a hub was launched earlier this year in Ohio. The NaviGuide program, created by United Church Homes in Ohio, offers these types of services to its 166 clients. The program was inspired by a family crisis for its creator Terry Spitznagel, senior executive vice president and chief growth officer for United Church Homes. Spitnagel said, “I’ve been in senior services for three decades, but I just fell apart trying to help my father navigate the aging journey. I couldn’t manage it.”

The article sees the NaviGuide program as a positive step in the right direction. “If programs like United Church Homes’ NaviGuide are proven financially viable or federal or state governments earmark money for caregiving navigators, you may start seeing these experts pop up around the country.”

In fact, other recent reports echo the Nexus recommendations.

“There are real opportunities to move forward on this,” said Kramer. “But it’s going to take keeping the issue in the limelight and building momentum and seizing opportunities.”

And, the article suggests, “It may also require more people finding themselves thrust into becoming family caregivers or needing to coordinate care.”

Said Tumlinson: “You have to go through it and then be stunned. Then you say, ‘Why is this not being fixed? How is this possible?'”

Read the article at Next Avenue.

Read the Nexus Report
Read the Nexus Survey

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Partnering for the Future - NIC Spring Conference 2023

2023 NIC Spring Conference

Senior housing and care leaders are convening in San Diego to discuss new opportunities that provide better outcomes of care for older adults through more effective integration of healthcare services and senior housing. The NIC Spring Conference is designed for anyone in healthcare or senior housing looking to connect, develop long-range strategic partnerships, and innovate new models of care and housing on behalf of older adults.

Nexus Fellows in attendance include Bob Kramer, Anne Tumlinson, and Sarah Thomas.

Anne Tumlinson will be presenting:

Pathways to Value-Based Healthcare Partnerships

Expert highlights senior housing-healthcare collaborations 

Healthcare is rapidly moving from brick-and-mortar facilities into the home. The
pandemic accelerated this trend, demonstrating that hospital-level care can be
delivered safely and conveniently where people live.

Momentum is growing for innovative partnerships between healthcare providers
and senior living properties—with potential for better clinical outcomes and reduced
healthcare costs.

Learn why integrating senior housing and healthcare matters to operators and
investors and learn about pathways to partnerships.

To register visit, NIC.

Long-Term Care Solutions

Navigating the Maze of Long-Term & Post-Acute Care: A Report by Nexus Insights

When an older adult experiences a crisis that requires post-acute or long-term care services and supports, they and their caregivers must make critical decisions, fast. What awaits them, however, is a maze of dead ends and poor information that stand in the way of getting the help they need.

“Older adults and their families enter a maze of twists and turns, dead ends, and wrong way streets when a life crisis forces them to consider their care options. Critical decisions about long-term care must be made quickly, with scarce information or resources, let alone supportive guidance to assist them in their time of crisis.” – Bob Kramer, founder of Nexus Insights

In February 2022, Nexus Insights hosted their inaugural ‘Nexus Voices’ session with 18 leading experts in the fields of aging policy, long-term care, senior housing and caregiver advocacy to talk through and tackle this issue.

The Outcome: A Nexus Voices Report

The result is the recently published report, “Where Am I, Where Do I Go: The Missing Entry Point to Long-Term Care Solutions for Older Adults and Their Caregivers”. This comprehensive and actionable report highlights the lack of infrastructure to help guide older adults and their families to long-term care services. The report proposes “Navigation Hubs” to help families understand their long-term care needs and select the best options for them. These hubs would serve as central doorways to existing supports and services—whether it’s home-based care, transportation or meal services, senior housing or nursing home care. The hubs would have a national presence but a hyper localized focus with counselors, or navigators, who understand the resources available in their communities and how to help older adults and their families access them.

“The factors that shape care decisions vary from family to family, but all families need an easy-to-use, accessible hub of information that clearly communicates the options that are available to them in their community,” said Anne Tumlinson, CEO of ATI Advisory and a contributor to the report. “With a growing number of older adults needing care, we have to act now to build the care infrastructure families need.”

Discussion participants outlined four primary responsibilities of the Navigation Hubs. They are:

  • Discover & Assess the long-term care needs of older adults, their families, and caregivers.
  • Educate older adults, their families and caregivers on the housing and caregiving support available to them as well as funding sources.
  • Select & Connect older adults with the best long-term care setting, supports, and services that meet their needs.
  • Reevaluate the needs of older adults as their health and financial statuses change.

“You can’t solve a problem until you’ve identified it and defined it,” said Kramer.

“Then you’ve got to define what are the key components of any solution. And we’ve laid that out with the navigation hubs and their four functions. And then we asked what we could learn from the failures and the successes of programs to date, to create our criteria. Finally, the path forward must be a joint effort involving both the public and private sectors. We demonstrated that there are aspects of differing programs from government-funded resource centers to tech-enabled employer options to private-pay models that could be incorporated into this solution.”

An Urgent Problem

In its conclusions, the report urges quick and decisive action to build navigation services for older adults that put families in the center. The family in crisis needs help now and cannot wait for lawmakers and government agencies to overhaul the long-term care infrastructure. This requires a national commitment to increased funding and an openness to reimagine existing solutions. Existing public, private-pay and employer-based programs could work together to make these hubs a reality by combining their infrastructure, experience and delivery models.

The Nexus Voices Participants

Nexus Insights Host Committee

  • David Grabowski, PhD, professor, Harvard Medical School, fellow, Nexus Insights
  • Bob Kramer, founder & fellow, Nexus Insights, co-founder, former CEO & strategic advisor, National Investment Center for Seniors Housing & Care (NIC)
  • Caroline Pearson, senior vice president, health care strategy, NORC at the University of Chicago, fellow, Nexus Insights
  • Sarah Thomas, CEO, Delight by Design/MezTal, fellow, Nexus Insights
  • Anne Tumlinson, CEO, ATI Advisory, fellow, Nexus Insights

Discussion Participants

  • Gretchen E. Alkema, PhD, former vice president, policy and communications, The SCAN Foundation
  • Alice Bonner, PhD, senior advisor for aging, IHI, and adjunct faculty, Johns Hopkins University School of Nursing
  • Ryan Frederick, founder & CEO, Smart Living 360, fellow, Nexus Insights (facilitator)
  • Lindsay Jurist-Rosner, CEO, Wellthy
  • Ruth Katz, senior vice president for policy, LeadingAge
  • Sean Kelly, president & CEO, The Kendal Corporation
  • Suzanne Kunkel, PhD, executive director, Scripps Gerontology Center, Miami University
  • Katy Lanz, chief strategy officer, Personal Care Medical Associates
  • Brian Petranick, group president, Neighborly
  • Cheryl L. Phillips, M.D., president and CEO, Special Needs Plan Alliance
  • Paul Saucier, director, Office of Aging & Disability Services, Maine Department of Health and Human Services
  • John Schall, CEO, Caregiver Action Network
  • Bill Thomas, chief independence officer, Lifespark, fellow, Nexus Insights

Read the Long-Term Care Access Report

Read the full report
Read the executive summary
Read the press release

About Nexus Insights

Nexus Insights is a think tank advancing the well-being of older adults through innovative models of housing, community and healthcare. We are a diverse group of thought leaders and stakeholders in aging and healthcare. Our goal is to spark change by sharing innovation across traditional silos, convening leaders from differing perspectives and bringing positive, life-affirming ideas into the public domain.

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Long Term Care Staffing Shortages

The Solution for Long-Term Care Staffing Shortages? Innovative Immigration Policies

Who will care for aging baby boomers? This was the question posed to an expert panel at an event that explored the links between immigration policy and long-term care policy. The online event was hosted by the Center on Children and Families of the Brookings Institute. It brought together leading researchers to present their findings on the role of immigration in caregiving, and to discuss the country’s caregiving needs, and policies to help address them.

Highlights of the discussion included:

  • The link between increased immigration and the increased support available for aging in place.
  • Economic benefits to family caregivers from larger labor pools supported by increased immigration.
  • Improved quality of care that results from a larger labor force and increased immigrant labor.

Anne Tumlinson, CEO of ATI Advisory and a Nexus Fellow, was on hand to provide her analysis of the policy landscape. She pointed to the severe economic impacts experienced by families and family caregivers that results from the lack of a national long-term care system in the United States.

Other challenges raised during the forum include the persistently low wages in the caregiving industry, enormous gaps in Medicare coverage for needed services for older adults, confusing variation by state of the types of services covered by Medicaid, and the difficulties that arise in addressing changing labor needs caused by inflexibility in employment-based channels for legal migration.

Possible solutions proposed included:

  • Addressing the inflexibility in the employment-based channels for legal immigration, to help address shortages and changing caregiving labor needs.
  • Creation of a national long-term care system to serve American families equitably and prevent financial hardships for families caring for loved ones.
  • Reallocating resources to address the persistent low wages in the caregiving industry, and to help create incentives for caregivers to remain in the field.

Read more at Brookings.
View the full discussion.

 

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Investing in HCBS

U.S. Senate’s Special Committee on Aging Addresses the Need for Investing in Home and Community-Based Services (HCBS)

Nexus Fellow and ATI Advisory CEO, Anne Tumlinson, was invited to testify at the Senate’s Special Committee Hearing titled “An Economy That Cares: The Importance of Home-Based Services”. Tumlinson advised that in order to reduce reliance on skilled nursing care, more money needed to be invested in Home and Community-Based Services.

“HCBS makes it possible for many individuals with LTSS needs to remain where they want to be, which is in their home. But unfortunately our home care system and its infrastructure are vastly underdeveloped and under-resourced to meet the growing need for services…If we don’t invest in them, American families are going to face very serious economic challenges, possibly even more than they are today,” said Tumlinson.

Read more at McKnight’s Long-Term Care News.
Watch the full hearing on the U.S. Senate website.

 

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NYSHFA NYSCAL

Anne Tumlinson and Bob Kramer speak at NYSHFA | NYSCAL’s Annual Conference & Expo

Nexus Fellows Anne Tumlinson, founder & CEO of ATI Advisory, and Bob Kramer, founder of Nexus, will speak on the final day of the conference.

The Future of Long-Term Care

Many of the impacts of the COVID-19 pandemic on long-term care were unanticipated and caused incredible disruptions to existing systems of delivering care. These disruptions changed many of the patterns in which providers operate and deliver care, including matters ranging from workforce shortages, reimbursement, technology and communication applications to transparency issues, market assessments and data analysis. This panel will discuss these and other topics in examing the future of long-term care and the changes that are temporary and those that are permanent moving forward.

 

The Annual Conference & Expo is NYSHFA | NYSCAL’s largest event. In addition to offering three days of education, covering a wide variety of topics that have appeal across many disciplines, this event includes an exposition to showcase the latest products and services available to the long-term care community. The audience is typically comprised of Owner/Operators, Administrators, Executive Directors, Medical Directors, DONs, and members of the Clinical Teams for SNFs, as well as all staff of Assisted Living Facilities. You won’t want to miss out on this opportunity to see inspiring speakers, attend great education, and network with industry peers!

More info at NYSHFA | NYSCAL

United States Senate Special Committee on Aging LIVE March 23

Anne Tumlinson, CEO of ATI Advisory, founder of Daughterhood, and Nexus Fellow, will testify on home and community-based services during “An Economy That Cares: The Importance of Home-Based Services”. Watch the United States Senate Special Committee on Aging speak LIVE at 10am ET Wednesday, March 23, 2022.

https://www.aging.senate.gov/hearings/an-economy-that-cares-the-importance-of-home-based-services

people holding hands

Medicare Advantage Hospice Carve-in Will Bring Challenges

According to Anne Tumlinson, Nexus Fellow and CEO of ATI Advisory, moving hospice benefits to more value-based payment models comes with some challenges and some growth opportunities for providers. Her remarks appear in a Hospice News article titled MA Hospice Carve-In Doubles in Size for 2022

Beginning in 2021, a number of Medicare Advantage plans began participating in a CMS experiment to provide hospice benefits to their members who elected to receive them. Typically, a MA member who elects to receive hospice benefits does so through traditional Medicare, not through their MA plan. Now in 2022 the number of MA plans participating in the program will double, going from 53 plans to 115. The experiment to allow MA payers to provide hospice benefits is slated to run for four years. Participation is voluntary for both payers and providers.

“In the short term, this growth represents primarily an opportunity for hospice providers in the markets where these plans are operating. The plans must pay Medicare rates and accept any hospice provider for a limited time,” Tumlinson told Hospice News. “The key opportunity/potential longer term threat is that the plans may move forward and establish special ‘value-based’ arrangements with a subset of the hospice market.”

Read full article

 

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Healthcare at Home Options for Seniors

More Healthcare at Home Options for Seniors with the Choose Home Care Act

Big news on the horizon for seniors and the aging services industry. A bill introduced last month in the United States Senate would allow for in-home care alternatives to skilled nursing facilities for rehab and post-acute services. The Choose Home Care Act, which was sponsored by Senator Debbie Stabenow (D-Mich.) and Senator Todd Young (R-Ind.), has bi-partisan support.

In a recent article in Senior Housing News, Anne Tumlinson, CEO of ATI Advisory, Founder of Daughterhood, and a Nexus Fellow, weighed in on the winners and losers, should this bill become law.

It would be a big win for seniors, allowing eligible Medicare patients to receive extended post-acute care services at home, rather than in a nursing home, “without placing undue burden on families to care for them.” According to Tumlinson, “The benefits are long overdue.”

Qualified home care agencies would also benefit, according to Tumlinson, with an additional avenue for billable services. “This legislation would essentially allow home health agencies to compete with skilled nursing facilities,” she said.

According to Tumlinson, the flexibility to consumers means more overlap in the post-acute services that skilled nursing facilities and home health care agencies could offer. Skilled nursing facilities may view the Choose Home Care Act as a threat. In fact, the American Health Care Association has expressed concerns that “it would supplant existing benefits and increase out-of-pocket costs.” If the bill passes, it may provide opportunities for private pay senior living providers, Tumlinson explained. “They can entertain partnerships with qualified home health agencies. For instance, they might team up with a Medicare-certified home health provider that will receive the expanded Medicare payments to care for residents that are recently discharged from the hospital, while the senior living provider would be able to collect the private-pay rent.”

In addition to bi-partisan political support, the legislation has broad support, including AARP, home care advocacy groups, and senior housing organizations such as LeadingAge. The bill was introduced in the Senate in late summer, and has been referred to the Senate Finance Committee.

Read the full story at Senior Housing News.

Follow status of the bill.

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ATI Analysis of Medicare Population Needs and the Critical Role of LTC Pharmacy

As many as 70 percent of individuals who reach age 65 will experience severe long-term-care (LTC) needs before they die. Those needs might range from help with managing their finances or medications, to help bathing and getting dressed. Having LTC needs does not necessarily correspond to living in a long-term care facility, however. Instead, people with LTC needs may live and receive services at home or in other community-based settings. 

Unfortunately for those living outside of LTC facilities, they face barriers to getting the assistance they need. A study conducted by ATI Advisory, in partnership with the Senior Care Pharmacy Coalition (SCPC), found that “state and federal policy and health plan requirements can create barriers that restrict people aging outside facility settings from accessing long-term services and supports, including LTC pharmacy.” 

As a population with high prescription drug utilization, access to LTC pharmacy is especially important to Medicare beneficiaries with LTC needs. The study found, however, that despite the pivotal role that LTC pharmacies play in the care of those with LTC needs, this role is not widely understood or acknowledged by individuals, caregivers, policymakers, and payers. 

Moreover, the study found that Medicare beneficiaries with LTC needs are demographically different from those without LTC needs in several important ways. The population studied was statistically “more likely to be Black or Latinx, female, dually eligible for Medicaid, clinically complex, and have higher healthcare and prescription drug utilization than beneficiaries without LTC needs.” Addressing the barriers to access to LTC services is necessary to work toward parity in access to services, coverage for services, support for caregivers, and equity in outcomes. 

Read the study outcomes.

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Tag Archive for: Anne Tumlinson

Partnering for the Future - NIC Spring Conference 2023

2023 NIC Spring Conference

Senior housing and care leaders are convening in San Diego to discuss new opportunities that provide better outcomes of care for older adults through more effective integration of healthcare services and senior housing. The NIC Spring Conference is designed for anyone in healthcare or senior housing looking to connect, develop long-range strategic partnerships, and innovate new models of care and housing on behalf of older adults.

Nexus Fellows in attendance include Bob Kramer, Anne Tumlinson, and Sarah Thomas.

Anne Tumlinson will be presenting:

Pathways to Value-Based Healthcare Partnerships

Expert highlights senior housing-healthcare collaborations 

Healthcare is rapidly moving from brick-and-mortar facilities into the home. The
pandemic accelerated this trend, demonstrating that hospital-level care can be
delivered safely and conveniently where people live.

Momentum is growing for innovative partnerships between healthcare providers
and senior living properties—with potential for better clinical outcomes and reduced
healthcare costs.

Learn why integrating senior housing and healthcare matters to operators and
investors and learn about pathways to partnerships.

To register visit, NIC.