Providers that offer navigational support for aging members that help them transition into safe, quality, vibrant housing build more value into plans and realize marked savings.

After a serious hospital stay or major life upset — the “5 Ds” including Divorce, Disability, Downsizing, Disasters, and Death — family members are often thrust into a caregiving role and inevitably, housing is an issue. Only about 10% of older adults will transition into assisted living, leaving the rest to navigate “what’s next.” 

Who will help your members navigate care? And consider the cost if safe, affordable and supportive housing is not in place for your members. For plan providers, the return on investment for delivering a care navigation resource that can triage a member’s housing, transportation and nutrition needs is significant. And when plans can partner with a single source, it eases these difficult life transitions. 

With housing as the most complicated social determinant of health (SDOH) to navigate, plans that give members turnkey access to a housing benefit with wrap-around support can reduce costly healthcare services and give members peace of mind — along with real value from their Medicare Advantage plan. 

Many plans contract with vendors who can arrange for transportation to appointments or meal delivery. But the housing piece is usually missing. It often rests under the radar because providers are not always aware of members’ life transitions. 

You can change the trajectory. The payback is improved member retention and satisfaction, better plan ratings, and reduced expenses across the board. 

The Cost of Living 

At Upside, we understand that housing is the core. It’s the top tier in a hierarchy of needs to stay well and age in place. And with the new measure for HEDIS (Health Effectiveness and Data Information Set) that includes Social Need Screening and Intervention (SNS-E), plan providers must address SDOH factors including housing. 

How can you deliver a housing benefit in an efficient, cost-conscious and effective way?

The solution: a scalable, fully managed living option for older adults with modern apartments in vibrant, safe, amenity-rich communities along with a geriatric care manager that helps members navigate decisions and access other services. 

Housing is the core of SDOH. With health plans now responsible for offering SDOH screening and intervention — star ratings depend on it — how can they deploy a resource that is cost-effective and valuable to members? Implementing widespread screening and offering interventions is a challenge for many plans, particularly for mid-sized and regional providers that contract with vendors for basics but are not equipped with in-house resources or navigational support to find stable, quality, affordable housing. But we know housing is the foundation of assuring members’ whole health. Without it, other services that plans offer will not completely meet members’ needs or fulfill the HEDIS measure.  

Your members have diverse needs. Housing is central to maintaining health over the long-term. But the additional services members require can vary based on SDOH screening results. That is why Upside can offer providers a comprehensive suite of living and concierge services — supports that can be tailored to members’ needs. This white glove approach allows plans to only utilize what they need. Some providers need to fill the housing gap only. Others realize the cost and convenience benefits of partnering with a single source that can do it all. 

ROI is in the Research 

Better ratings, member retention and cost reduction are reasons why plan providers should offer a housing benefit that includes SDOH supports as needed. Proof is in the numbers.

The Commonwealth Fund conducted a study and assembled an evidence guide for Partnerships to Address the Social Determinants of Health that underscores how housing can significantly reduce expensive forms of healthcare and reduce costs. Among a subset of eight profiled studies that compared permanent supportive housing or traditional housing to a control group:

  • E.R. visit rates were 14% to 54% lower
  • Hospital admission rates were 15% to 42% lower
  • Hospital days were 29% to 43% lower

When appropriate housing was in place, total healthcare costs were lower. 

According to a Humana population health study, 60% of health is impacted by social factors, environmental conditions and lifestyle behaviors.

The bottom line for plans: Giving members access to navigational support so they can easily access housing options, care assistance and lifestyle needs helps them age in a healthy way and reduces costs across the board.

Supporting Members’ Evolving Needs

It pays to give members convenient access to navigational support – a geriatric care manager that can assist with SDOH screening and identify factors like housing and transportation that can keep them healthier and happier. Plans that invest in a housing + support resource that can “age with members” based on their changing needs can reduce healthcare utilization rates and related expenses. 

What makes Upside different is our approach to coordinating and providing amenities that contribute to a higher-rated and cost-effective plan. 

  • Scalable housing in amenity-rich apartment communities
  • Comprehensive health-risk and housing assessments
  • Intelligence regarding members at low, moderate or high risk factors for chronic conditions, medication noncompliance, preventive care and other SDOH issues
  • Technology that proactively identifies care gaps
  • A geriatric care manager to coordinate SDOH services 
  • Concierge services that promote a healthy lifestyle 

Upside can scale up or down with members’ needs.

Upside serves 97 markets across 42 states and will be offering housing solutions in all 50 states by early 2023. We work with a wide range of health plans and long-term care providers with varying added-value services and benefits in place. Members can lean on a geriatric care manager that facilitates SDOH services like transportation to appointments, meal delivery, social activities and more. And for so many families, this one point of contact is the missing piece they really need.

Get ROI from value-added resources. Meet members’ evolving needs as they age in a savvy, financially responsible way and give them the resources they expect.