22 - 24 March, 2017
[Program Area of Focus- Economic, Capital & Policy Trends]
The U.S. general election outcome shifted the near-term economic outlook, with many now predicting faster growth and higher interest rates in 2017. In this session, NIC Chief Economist Beth Mace will provide an overview on macroeconomic trends and NIC data on the seniors housing and skilled nursing sectors through fourth-quarter 2016, including occupancy rates, supply and demand conditions, and a comparison of metropolitan market performance across the U.S. Capital market experts will also share their strategies for navigating changing market conditions.
[Program Area of Focus - Capturing Value]
The federal government is pushing to reduce the cost of care while improving outcomes, especially for frail seniors, by shifting away from traditional fee-for-service to value-based care delivery and payment strategies such as alternative payment models, bundled payments, and Medicare Access and CHIP Reauthorization Act (MACRA). Key to these strategies is the assumption of risk, whether for episodes of care or in a population health model. This session will explore further regulatory changes likely in 2017, and what they may mean for seniors housing and skilled nursing.
[Program Area of Focus- Capturing Value]
Discover new collaborations seniors housing and skilled nursing operators are exploring to partner with innovative care delivery and coordination organizations in home care, transitional and chronic care management, and enhanced primary care. These service providers are bringing forward new capabilities that add value and help operators serve frail seniors effectively, efficiently, and profitably. Hear from operators and investors in senior care and home care about the collaborative, cross-silo partnerships they’re pursuing, and why these relationships drive both operational and financial success and create long-term value—for all partners.
• identify the larger trends in risk-based payment that are pushing clinical and operational collaborations
• hear the investor perspective on senior care collaboration and how it could affect deal valuations
• get the inside story on the home care investing craze and how senior care collaboration offers a crucial distribution channel for scale
About one-third of Medicare beneficiaries are enrolled in managed care today and nearly half of all seniors are expected to be enrolled within the next 10 years. But as more senior care organizations experiment with managed care products, strategies, and partnerships, will they add value to their operations and enhance the quality of care? This session looks at the unique business opportunities and challenges that operating companies and providers face in the seniors housing, post-acute care, and long-term care markets.
[Program Area of Focus- Economic, Capital, & Policy Trends]
You did the research and developed in a great market. But how do you respond when lease-ups are slower than expected? Why do some properties fare well, while others do not? In this session, get the latest NIC MAP® seniors housing data by property type, including memory care, to find out where supply is low and where development is hot. Then follow along as experienced panelists share their strategies for adjusting business plans or pro formas when new competition changes the competitive landscape and lease-ups fail to materialize as forecasted.
• discover how select seniors housing property types—independent living, assisted living, and memory care—are performing by metropolitan market across the U.S.
• get practical and tactical strategies for succeeding in a competitive landscape
• hear contingency plans that can be implemented when a property fails to meet its pro forma
[Program Area of Focus- Creating Successful Partnerships]
In a world rapidly changing from fee-for-service to a setting-neutral, value-based environment, all health care providers—including those in seniors housing and care—will have to coordinate and partner to expand their capabilities. In this session, get expert insight from a panel of senior care providers and investors, as well as private equity investors in non-real estate care businesses. The panelists will share the practical realities of investing in a world where senior living and its associated care is blended with home care as well as other programs and services in order to complete a coordinated continuum.
• discover avenues of participating in an owned, partnered, or third-party managed matrix of care
• explore different investment models, from a real estate-centric approach to an operating-oriented focus, and find out which types of investors are considering or even targeting investments within a coordinated continuum strategy
Uncertainty around skilled nursing’s outlook in the changed political landscape continues to create a disruptive environment, and operators and capital providers are adapting their strategies to prepare for additional uncertainty and future success. The market has reacted with increased merger and acquisition activity—from divesting of skilled nursing holdings to investing heavily in the sector. This session will build on the earlier presentation “The Economy in 2017 and Its Impact on Seniors Housing & Care,” providing you with an in-depth look at NIC’s skilled nursing data and trends. Hear the perspectives of two operators and a REIT on how they have each embraced and adapted to the current environment.
Technology can potentially be the most powerful tool to unlock new value for operators/providers, stakeholders, and consumers. In this session, discover how to harness technology to facilitate communication across organizations and empower seniors to manage their own clinical care and enrich their personal lives.
The focus on quality and value is pressuring operators/providers to seek solutions outside their building walls. What’s key is finding partnerships not for the sake of partnering, but to collaborate on achieving shared operational and financial goals that ensure success for both organizations.
The increasing focus on value has not escaped investors’ notice. Venture capital alone invested more than $200 million in home care companies in 2016, and investors who traditionally focused on biotech and pharmaceutical health care spaces have funded new primary care service enterprises that are innovating care for frail seniors. This session will explore how these companies who are targeting frail seniors use sophisticated platforms designed to increase value to payors and consumers, and why investors increasingly are paying attention.
Collaborations beyond customary real estate transactions are presenting new opportunities for investors, operators, and providers of senior care products and services. But determining the worth of these changing business models is a challenge. In this session, a panel of experts will evaluate changes to valuation methodologies and metrics in the evolving health care delivery landscape.
• understand how appraisers, investors, and operators may assess the true value of a potential acquisition
• determine the impact of value-based payment models on pro forma calculations
• learn about the health care metrics lenders are using to evaluate quality of care
• hear about current valuation trends, including cash flow multiples and desirable cap rates, and how reimbursement policy changes can impact valuations
Measuring quality matters—not just to increase overall enterprise value but to demonstrate that value to referral partners and increasingly savvy consumers. Both private-pay seniors housing and government-reimbursed skilled nursing operators need to track and demonstrate quality outcomes of the services they provide. Hear from a panel of experts on the most prevalent quality indicators being measured today and the metrics some operators are exploring in order to deliver and demonstrate value whether it be to consumers, payers, physicians, hospitals or lenders.
• discover why quality metrics are key to mitigate risk and provide better revenue streams
• explore current health care quality metrics and understand how the new presidential administration may influence them
• understand how seniors housing and skilled nursing operators will need to demonstrate an alignment of interests with hospital systems and physician groups
Looking down from 10,000 feet, the seniors housing sector is in equilibrium. Occupancy has oscillated around 89.9% for the past three years, and demand has largely matched new supply, despite the run-up in construction since 2013. Zoom in a little closer, however, and the view changes. Results often vary significantly at the local level, proving that the old adage “location, location, location” can ring true. In this session, Beth Mace will discuss seniors housing conditions at the local market level, highlighting the contrasts between the generally healthy markets in California with those in Texas that are struggling with oversupply.
• identify which markets performed well in 2016, which missed the mark, and what factors influenced their performance
• discover critical concepts for gauging winning and losing markets
• hear which markets offer opportunities with the most promise
Providers across the care continuum are responding to both changes in Medicaid programs at the state level that are designed to limit or cap state financial exposure, as well as a potential overhaul of the federal funding model. In this session, panelists will give you a deep dive into Medicaid’s approach to long-term services and supports (LTSS) in three states—California, Texas, and North Carolina—and what these approaches may mean for models in other states. Hear their predictions for how Medicaid could change in the future, including the potential transition to block grants, the growing proliferation of home and community-based services (HCBS), and the impact of the increasing reliance on managed Medicaid organizations (MCOs).
• hear how changes to LTSS and HCBS could influence market share
• explore approaches for successful partnerships with MCOs
• understand why some providers are using creative approaches to capture Medicaid revenue streams, including forming managed care plans and ACOs as well as expanding services to include home care and home health
• get insiders’ perspectives on the latest Medicaid developments and NIC’s data on top-level trends through 2016
© National Investment Center for Seniors Housing & Care (NIC)
1997 Annapolis Exchange Parkway, Suite 480, Annapolis, MD 21401
Phone: (410) 267-0504 | Fax: (410) 268-4620