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Independent and Assisted Living: Complex Populations Deserving Integrated Housing, Clinical, and Lifestyle Support


1.6 million Medicare beneficiaries live in independent or assisted living communities nationwide. The complex care needs of these individuals surpass the needs of those living in traditional private housing, resulting in higher Medicare utilization and spending. However, silos between senior living communities and medical services create barriers to integrating clinical and residential services.


This study is part of a broader effort to quantify and detail the demographics and experiences of older Medicare beneficiaries living across a spectrum of housing options. ATI Advisory, in partnership with the American Seniors Housing Association (ASHA), evaluated survey responses and claims data for Medicare beneficiaries included in the 2018 Medicare Current Beneficiary Survey (MCBS). The MCBS is an annually fielded, nationally representative survey commissioned by the Centers for Medicare and Medicaid Services (CMS).


Policymakers should equip senior living operators with the tools to address and integrate the medical needs of their residents, and to prevent escalation into costlier settings of care. Opportunities include technical assistance supports to senior living communities, pilot programs that test residential-medical integration, and a targeted Medicare Advantage Special Needs Plan (SNP) for senior living communities.


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