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Jody Holtzman interview

Trends, Challenges and Opportunities in the Longevity and Aging Industry – A Jody Holtzman Interview

COVID-19 has been a tremendous challenge for everyone, but it has shone an especially bright spotlight on how underserved our aging population really is. We sat down with Nexus Fellow and Senior Managing Partner at Longevity Venture Advisers, Jody Holtzman, to discuss trends, challenges and opportunities in the longevity and aging industry in this new world.

Jody is a well known leader in the aging and longevity world, having spent the past 15+ years in the field, preceded by a career in strategy consulting. His work in aging includes a 12 year stint at AARP where he ran research and was senior vice president of thought leadership and market innovation. 

 

NEXUS INSIGHTS – You have spoken about Baby Boomers and their lack of interest in traditional long-term care communities, especially assisted living. Tell us more about that.

JH – First, it is hard to generalize when you are talking about a population of just over 70 million people, which is the current Boomer population in the US. That’s more people than in the UK, France, or Italy. So, let’s just establish that one size does not fit all and there will always be a segment of Boomers for whom traditional long-term care settings are attractive. However, even before the pandemic, occupancy rates across independent and assisted living already were at a low, while the age of new residents continued to climb well into the 80s. And the mental image and mental model of long-term care communities for Boomers was one of nursing homes where people are warehoused to die. Since the pandemic this image has only been deepened as Boomers saw nursing home death rates, as well as experienced such with their own older loved ones.

There also is something else going on when we look at how Boomers view long-term care. And that is, they simply do not see themselves in those settings. It does not jive with their own self-image. This came out in spades to me the first time I spoke to a LeadingAge conference and did this exercise with the audience. I asked everyone to stand if they proudly participate in the management of any type of long-term care community. Three hundred and fifty people jumped up. Smiles all around! Then, I asked them to remain standing “if you are looking forward to the day you live in your own facility.” And the overwhelming majority of the audience sat down. These were people on the front lines of senior living, committed to making life better for older people. But they also, overwhelmingly, were Baby Boomers. And they did not see themselves in senior living. So, something has to change.

There is something else going on when we look at how Boomers view long-term care. And that is, they simply do not see themselves in those settings. – Jody Holtzman

NEXUS INSIGHTS – You talk about how the pandemic has shaped how and where health and healthcare happen. Tell us about the trends that you are seeing.

JH – Trends over the past year, both within and outside senior living, have increasingly confirmed that the home is and will continue to be the focus of health, care, and connected living. The growing consensus across the healthcare community got a boost from the orientation embedded in the concept of social determinants of health (SDOH) which is encapsulated in the view that health is a function of one’s zip code and the conditions of life in a geographic area. Health is now, officially, “beyond medicine.”

In parallel with the new focus on SDOH over the past year, digital health has exploded. While the health benefits of home-based care were being proven, along comes COVID and people are told to lock down and remain in their homes. Telehealth, telemedicine, and other virtual communications, became the dominant market response in healthcare and society more broadly. All in combination reinforcing the centrality of the Home and further boosting demand for more home and community-based products and services.

 

NEXUS INSIGHTS – You work with a lot of healthcare companies in the aging space. How are they dealing with these new trends and market opportunities?

JH – In response to the pandemic, and to both longstanding needs and those recognized by looking at health through the lens of SDOH, CMS has added a growing list of non-traditional, supplemental benefits that may be reimbursed through Medicare Advantage, but not traditional Medicare. Startups and others have responded with an array of new offerings covered by new reimbursement codes. And MA plans have been increasingly adding them to services already offered in their plans. While payers have had the near-term benefit of attracting new customers through product/service-based competitive differentiation during Open Season, the longer-term health benefits and attendant cost savings have yet to be proven. And this brings us to a dilemma. While the need and availability of a growing list of technology-enabled products and services has been established, customer/patient adoption is still low, and returns on investment have been as well.

For startups, this is concerning because, in many cases, they are being directed by investors and others to build their channel strategies around Medicare Advantage. Even if the deals with payers are all gain-share arrangements without requiring cash outlays by the payers, they still are making an investment in time and dedicated resources, if only to track progress. The question needs to be asked and monitored – how long will MA plans include offerings that garner limited customer uptake? If nothing else, the current terrain calls for a diversified go-to-market strategy that is not solely dependent on Medicare Advantage.

Sarah Thomas and Bob Kramer

Let’s Quit Talking to Ourselves: Sarah Thomas and Bob Kramer on the Future of Senior Living

“They’re coming for our space,” said Sarah Thomas, CEO of Delight by Design, and a Nexus Insights Fellow. Thomas is an accomplished leader of innovation and a global aging expert, advising startups, large corporations and investors.Those of us in senior living and senior care need to lift our heads to see what’s coming. We need to see how we can be part of creating what’s ahead of us.” 

Thomas recently joined Bob Kramer, Founder & Fellow at Nexus Insights and Co-founder and Strategic Advisor for NIC, for a conversation on Senior Living Foresight TV, entitled “Let’s Quit Talking to Ourselves: Moving the Conversation Outside Senior Living.”

The two discussed the increasing presence of investors and large corporations in the aging industry. Kramer and Thomas agreed that outside companies can be perceived as threats. But a wiser approach, they advise, is to see opportunities for productive partnerships.

“We must elevate our voice to be heard beyond our own walls,” said Thomas. “If we don’t want to partner with them, we may be replaced. So we need to look at what is not our domain expertise, and to identify gaps and consumer expectations that we’re not meeting.” Kramer agreed, observing that larger companies have greater logistical support, and greater expertise in certain domains. The key is to look for partners who can help close those gaps.

“We must elevate our voice to be heard beyond our own walls.” – Sarah Thomas

Thomas and Kramer discussed the importance of ageism, which is everywhere, and impacts everyone, and not just the older demographic. Thomas’s consulting work includes helping investors understand the marketplace, and to see the true needs and not the perceived needs “that are often misperceived,” and based on ageist ideas and stigmas. The two agreed that communities need to know their own value proposition, and to know how to communicate it, if they want to have a bigger seat at the table.

The discussion also touched on the value of universal design. “If we’re designing for all instead of designing for old, then we have beautiful designs that are also functional,” Thomas explained. Her experience includes work with the integration of robotics and fashion. The lesson for the aging industry, she suggested, is that beautiful designs help accelerate the adoption of new ideas, a philosophy that should be applied to senior living and senior care.

The two also talked out the potentially lasting impact of the pandemic on the industry. “The pandemic reinforced the idea that senior living is all about care,” Kramer said. “Ultimately we have to offer an experience that is aspirational, that is about a sense of belonging, about the joy of being alive, and not just making it through the day.”

See the whole conversation:

Five Predictions for Senior Living Trends authors

5 Predictions for Senior Living Trends in 2021

In 2020, COVID-19 slammed many industries, but the hardest hit was definitely senior living.

But 2021 offers leaders in this industry several unique opportunities to turn the corner. An immediate need is to prevent additional infections and make communities safer, in part through effective distribution of vaccines. However, even as senior living executives manage the ongoing crisis, they must build towards the future. The pandemic didn’t create many of the problems that are now being spotlighted as glaring issues in the senior housing world. We are now at a crossroads, a perfect opportunity to renew the mission of senior living.

We predict five trends will be critical to Senior Living in 2021. Will your organization seize the moment or miss the boat?

1 – Digital Transformation

Prediction 1 - Digital Transformation

Our industry has lagged behind most when it comes to technology. This is no longer an option. The COVID crisis showed that assisted living properties, independent living communities, and skilled nursing facilities must have cutting-edge digital systems for three purposes:

  • Peace of Mind – Residents must be able to communicate from their rooms with facility staff and with family members, even amid lockdowns. Not just audio connections, but video links that prove loved ones are OK.
  • Care Delivery – What used to be “way out there” has become normal. Doctors and other health professionals can use videoconferencing and other tools to diagnose and monitor residents. The Centers for Medicare and Medicaid Services is not only paying for telehealth – CMS is encouraging it.
  • Connection – COVID taught us that physical distancing cannot become social isolation. When disease outbreaks require residents to remain in their rooms, digital activities must replace in-person gatherings. The alternative is depression, aggravated health conditions and rapid decline.

2 – Onsite Healthcare Delivery – With Partners

Prediction 2 - Onsite Healthcare Delivery - with Partners

Healthcare at many senior living communities has long amounted to a van shuttling residents to the doctor’s office or an ambulance ferrying sick residents to the hospital. But this approach caused fear during COVID, given the risks of contracting the disease in hospital settings.

Residents and families will not stand for such physical outsourcing of care anymore. And there is another way. Healthcare services can be delivered onsite where seniors live.

The key is partnerships. During the pandemic, many senior living organizations forged relationships with local providers, who sent healthcare professionals into assisted living and independent living communities. Those same providers can offer remote, digital care to residents as technology systems improve.

3 – Trust Through Transparency – and Data

Prediction 3 - Trust through transparency - and data

Besides elderly Americans dying by the tens of thousands, another casualty of COVID has been trust in senior living organizations. The industry’s black eye isn’t entirely fair. COVID is most lethal to those over 75 with underlying health conditions, which describes the overwhelming majority of senior living residents. What’s more, the media sometimes lumps together outdated and overwhelmed nursing homes with upscale independent living companies.

Still, leading senior living providers will proactively rebuild confidence among residents, family members and the public. Transparency is key.

Any company with a congregate living setting has to be willing to publish real-time information on such matters as COVID infection rates, and deaths, risk mitigation protocols, employee vaccination practices and staffing policies.

4 – Workplace Culture and Servant Leadership – at the Fore

Prediction 4 - Workplace culture and servant leadership - at the Fore

Too many companies in the industry treat workplace culture as a “soft” “nice to have.” That’s a risky approach today. Data from Activated Insights and Great Place to Work shows that the Best Workplaces in Aging Services have lower turnover rates and better care outcomes.

During the COVID pandemic, reliable staffing and sound care have been more critical then ever. Not only to get sick residents needed treatment, but to avoid instances of neglect that ruin reputations.

A great culture is one where staff members feel pride, experience camaraderie and trust leaders. To cultivate that trust, managers and executives must practice “servant leadership” – seeing yourself not as the “superior” but the kidn of boss who will step in to serve meals and unclog toilets as well as to address the family concerns staff often bring with them to work. Humility is the new superpower.

5 – A New Story for Senior Living – and Society Overall

Prediction 5 - A New Story for Senior Living - and Society Overall

In recent decades, our industry has gravitated to a message focused on caregiving. We’ve lost our aspirational north star – that residents in our communities have much to contribute and can feel deeply alive in their later years. COVID gives us a chance to reframe our value proposition and mission.

The new story for senior living has to be about meaning, human connection and community in addition to care. This means redefining our activity directors as “purpose matchmakers,” breaking down the walls that make our complexes a form of “senior apartheid” and looking for language that moves us away from the “declinist” narrative of old-age.

We can turn outside our industry for help. Even as COVID devastated many of our senior communities, it caused you people to empathize in new ways with their older neighbors. And elders are a vital resources to help America recover from COVID – already, they are serving as tutors to help close education gaps that have widened during the pandemic.

The Five Predictions Infographic

Five Predictions for Senior Living Trends 2021

Click to download as pdf

 

Dr. Jacquelyn Kung is CEO of Activated Insights, the senior care partner of workplace culture authority Great Place to Work. Robert G. Kramer is founder of think tank Nexus Insights and former CEO of the National Investment Center for Seniors Housing & Care (NIC), a resource for data and analytics for the senior housing and care industry. Ed Frauenheim is co-author of several books on workplace culture, including A Great Place to Work for All

Dallas Morning News Senior Living and COVID

Nexus Insights Fellows offer 5-point plan for fixing the post-COVID senior living industry

“COVID-19 gave the senior living industry a black eye.”

That is the opening statement of a provocative op-ed piece in The Dallas Morning News by Jacquelyn Kung, CEO of Senior Care Group at Activated Insights and a Nexus Insights Fellow, with Nexus Insights Founder and Fellow Robert G. Kramer and author Ed Frauenheim.

“Few industries have been as wounded by COVID-19 as the senior housing and care sector,” the article claims. It goes on to say, “The statistics are eye-popping. ‘Residents of long-term care facilities constitute less than 1% of the U.S. population, yet 43% of all COVID-19 deaths through June occurred in those places,’ AARP Bulletin reported in December. ‘The number has changed little since.’”

But the op-ed, entitled, “How the senior living industry can heal itself and all of us” provides both hope and a game plan for helping the industry recover.

The authors, all veteran observers of the senior living industry, offer five practical solutions for “repairing and renewing the industry.”

Read the full article here.