Reducing Hospitalizations by Integrating Health and Housing

Quantifying the Value of Healthcare Investments by Senior Housing Operators


Over the next 15 years, 80 percent of the United States population will experience one or more chronic conditions, costing more than $42 trillion in medical care spending and losses in employment productivity. The frail elderly population in the United States suffers from multiple chronic conditions, uses the most health care services and, not surprisingly, drives most of the costs in our health care system. As baby boomers continue to age, millions more Americans will join this vulnerable population, adding additional pressure to deliver quality outcomes at the lowest cost.

To address these challenges and enhance the resident experience, Juniper Communities, a Bloomfield, NJ-based national owner-operator of seniors housing, developed the Connect4Life model, which provides on-site comprehensive therapy, primary care, pharmacy and lab services, integrated with other services using a “high-tech/high-touch” communications protocol that transfers information through an Electronic Health Record (EHR) and coordinates care through a human navigator.

Juniper Communities asked Anne Tumlinson Innovations (ATI) to compare its Connect4Life outcomes and utilization data with data from the broader Medicare population to assess the outcomes of its investments.



To evaluate the potential importance of integrating health care services and seniors housing, we compared Connect4Life’s key outcomes to national data. We used the 2012 Medicare Current Beneficiaries Survey (MCBS) cost and use file to compare the health care utilization of Juniper residents with all Medicare beneficiaries and sub-populations of Medicare beneficiaries with functional and cognitive level-of-care needs similar to Juniper’s resident population.

Our study found that the Juniper population is much frailer and more at risk for high health care spending than the overall Medicare population. But, compared to similarly disabled and cognitively impaired Medicare populations living in the community and in seniors housing without integrated care programs, Juniper performed more than 50 percent better on inpatient hospitalization rates and more than 80 percent better on readmission rates.



The results affirm the potential of integrating select clinical care and services in a seniors housing environment that provides supportive services to those who have chronic conditions, functional limitations, and complex social needs. While Juniper’s population is older, frailer, and more cognitively impaired than the overall Medicare population, the study showed Juniper’s utilization of costly inpatient services and readmissions appears dramatically lower than for comparably frail individuals living in the community and in other seniors housing communities.

The results suggest an integrated program of services in seniors housing—like Juniper’s Connect4Life —can contribute to reducing the cost of care and services to Medicare beneficiaries residing in seniors housing. More importantly, the data points to the value of the Connect4Life model for managing population health because of its ability to efficiently target integrated care interventions in the high cost, high-need Medicare population.

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