How Memory Care Operators Can Better Collaborate With Health Systems

Memory care operators and health systems can better collaborate to improve dementia care while demonstrating value through cost savings and improved outcomes.

That’s according to Dr. John Sawyer, who is the co-director at the Center for Brain Health of Ochsner Health. Sawyer envisions a future where memory care operators and health systems can mutually benefit by offering more in-depth support to caregivers and better dementia care to patients.

But as it stands, the senior living and health care industries have quite a challenge ahead.

“The main model under which specialists have been trained is ‘diagnose and adios,’ where you give someone with dementia a diagnosis and refer them to the Alzheimer’s Association website, basically wishing them good luck,” Sawyer said during the recent Senior Housing News BRAIN conference in Chicago. “That’s not a wonderful way to provide care.”

Ochsner Health has more than 34,000 employees and 4,500 physicians across various specialties. The organization operates 40 hospitals and over 300 health and urgent care centers.

Confronting a ‘challenging topic’

Pivoting to emphasizing value in dementia care, memory care operators are swiftly finding ways to adopt value-based care models aim to improve health outcomes and realize health care cost savings.

He described the shift to value-based care for operators and healthcare providers as a “challenging topic,” aiming to enhance the value proposition and connect with dementia patients earlier to improve health outcomes. He cited examples such as keeping a person living with dementia at home safely through care coordination and caregiver support, potentially saving a family $100,000 in a year’s time.

“The point is, there’s certainly a value proposition in not just building more memory care facilities but also in finding ways to keep people safely at home,” Sawyer added.

Sawyer’s comments come as memory care senior living providers seek to enhance care offerings and operational efficiency through integrating technology aimed at improving resident care and staffing.

Ochsner Health’s Care Ecosystem is a care management program and health feasibility study for a dementia care program developed by the University of California, San Francisco, aiding people living with dementia.

In 2022, Ochsner received a $700,000 grant from the National Institute on Aging and National Institutes of Health to study the effectiveness of its dementia care as part of a network that received $7 million to study the Care Ecosystem model developed by UCSF.

Sawyer, who is also the medical director of neuroscience value at Ochsner, highlighted the challenge of meeting program outcome goals while carefully selecting participants for the Care Ecosystem program. People living with dementia must have moderate-stage disease and at least one unnecessary emergency department visit or hospitalization in the past 12 months.

“The “secret sauce” of the Care Ecosystem program lies in the relationships between the caregiver, the person with dementia, and the clinical team—establishing a plan to manage care needs on a monthly basis,” Sawyer said.

“One of the aims was to serve as a surrogate for risk because, as people know, there isn’t a caregiver burden score just existing in the medical record to help us identify who might be more stressed than others,” Sawyer said. “So you have to ensure you’re targeting individuals who can truly benefit from your intervention.”

With the assistance of a navigation team, caregivers discuss behavior mitigation strategies and act as a “guide” for the person with dementia, providing support over 12 months. Sawyer noted that patients in the program use services intensively in the first six months, with reduced usage in the latter half of the year-long program.

Influence of the GUIDE model, opportunities in memory care ahead

Some memory care operators are participating in the Guiding an Improved Dementia Experience (GUIDE) program from the Centers for Medicare and Medicaid Services (CMS).

First announced in 2023, the GUIDE model aims to extend the time individuals with dementia can remain at home while enhancing their overall health. It includes training for in-home caregivers and ensures continuous 24/7 support. The model also introduces a new payment system for participating providers to enhance patient care coordination.

“There haven’t been financially meaningful payment models for dementia care until GUIDE,” Sawyer said. “It represents a sustainable payment model for care.”

GUIDE aligns well with the Care Ecosystem program, and Sawyer noted that Ochsner is uniquely positioned to contract respite care from senior living providers and other healthcare organizations to receive reimbursement for memory support services.

Through the program, Ochsner Health achieved a 90% completion rate among participants and saved an average of $400 to $500 per participant per month.

“That presents a significant business case tied to cost savings, though proving it remains a challenge,” Sawyer said.

This addresses issues that senior living operators have increasingly faced over the past decade: finding new ways to achieve positive resident outcomes, seek reimbursement, and expand value-based care models.

Even as this shift towards value-based care gains traction in the industry, some leaders view it as a strategy spanning five to ten years. Seeking growth in value-based care is particularly challenging for smaller and mid-sized senior living operators, prompting some to form partnerships to achieve scale and mitigate risk.

“To make the business model work, you’ll need to scale it up and have 100 to 200 patients,” Sawyer said.

More than two dozen sites currently utilize the Care Ecosystem program and address caregiver needs through virtual visits. Participants in the program residing in independent living communities, who might otherwise avoid routine healthcare services due to overall good health, could benefit from the support services offered if someone in the household is showing slight signs of cognitive decline.

Sawyer shared Ochsner Health’s experience partnering with Lambeth House, a senior living community in New Orleans, to provide virtual visits and coach care staff for residents with dementia as part of a research study, with more projects on the horizon.

“Over time, this became a significant value-add for many residents,” Sawyer said. “Staff knew they had us to call when issues arose, rather than relying on uncertain responses or waiting for a psychiatrist’s call.”

Looking ahead, Sawyer envisions a landscape where demographic-driven demand and an aging U.S. population will compel senior living providers and healthcare organizations to innovate in solving future dementia care challenges. He emphasized addressing staffing issues and supporting care staff as critical for senior living operators entering 2025 and beyond.

“I’m curious about turnover in the senior living workforce and how it’s managed,” Sawyer said. “I believe that taking care of your people will lead to better care for residents and patients with dementia.”