Everything You Wanted to Know about Continuing Care at Home

Members | December 16, 2012

A new white paper from CliftonLarsonAllen explains the appeal of continuing care at home (CCaH) programs and provides answers to providers’ frequently asked questions about this emerging care model.

Continuing Care at Home: Evolution, Innovation, and Opportunity, a new white paper from CliftonLarsonAllen, explains the appeal of continuing care at home (CCaH) programs and provides answers to providers’ frequently asked questions about this growing care model.

Continuing care at home is a life care membership program offering the same kind of services as a Type A continuing care retirement community (CCRC) to consumers who choose to live in a setting other than the traditional CCRC.

The white paper highlights the experience of 4 LeadingAge members that sponsor continuing care at home programs: 

What is Continuing Care at Home?

According to authors Scott Townsley and Sarah Spellman, CCaH programs have a number of distinctive features:

  • Comprehensive services: In return for an entrance fee and a monthly fee, participants receive a comprehensive package of long-term services and supports. That package is designed to enable CCaH members to live independently at home as care needs increase. 
  • Access to campus: Some CCaH programs offer members access to amenities on campus, such as dining, fitness and social activities. Most programs also offer a range of social programs to foster interaction among members. 
  • Care coordination: Each CCaH member is assigned a care coordinator who gets to know that member personally. The care coordinator regularly assesses a member’s health and functional status, recommends needed services, and obtains and manages those services on behalf of the member. 
  • Pricing structure: Sound actuarial pricing is the key to operating a successful CCaH program. Usually, the pricing formula includes a 5-15% margin, which serves as a “risk buffer” in the event of adverse experiences. 
  • Benefits: CCaH programs have the potential to financially benefit the sponsoring organization’s campus and its residents, according to the white paper. CCaH programs help to spread out administrative costs for shared services. In addition, they tend to increase nursing home occupancy for Medicare Part A short-term rehab stays. The program also increases the utilization of ancillary services like home health and adult day care. 

Frequently-Asked Questions

The CliftonLarsonAllen white paper answers a number of questions that providers may have about CCaH programs, including:

  • Are CCaH programs just like long-term care insurance? 
  • Are actuarial projections accurate? 
  • What are the biggest risks in CCaH programs? 
  • How difficult is it to combine a CCaH program with a Program of All Inclusive Care for the Elderly (PACE)? 
  • Do CCaH programs compete with traditional CCRC campuses for the same market share? 
  • Do CCaH programs significantly boost occupancy in independently living, assisted living and nursing home facilities? 
  • Do current regulations provide enough protections for consumers? 
  • Do CCaH members use campus-based assisted living and nursing homes at the same rate as campus residents?

Future Opportunities

Townsley and Spellman conclude their white paper by suggesting that the CCaH model presents an opportunity for CCRC providers to be responsive to housing market trends and consumer preferences. 

In addition, they say, CCaH programs could serve as a model for health care reform.

“The Patient Protection and Affordable Care Act requires providers to consider new methods of payment for services, including bundled payment arrangements and other strategies to reduce health care costs,” the paper concludes. “We believe CCaH programs can serve as a proven model for care management and coordination for these new payment arrangements.”