Helping Plan Members Age in Place – Navigating Long-Term Care

Author: Nevin Folino

As a health plan provider, you engage on a daily basis with older adults and their families as they struggle to navigate care, health and housing. Aging is a journey. Benefits advisors often become quarterbacks for their members, connecting them to services within the plan or referring them to community resources that can help. 

But who is supporting you, the health plan provider, as you focus on:

  • Reducing costs
  • Improving quality
  • Capturing data
  • Optimizing health outcomes 
  • Retaining satisfied members

Meet Upside – Building Community that Advances Healthy Outcomes

Upside makes it simple for health plans to offer programs designed for specific populations, add supports to plan benefits, and address the leading cause of health decline: housing. Upside is the first comprehensive, vertically integrated housing benefit with a national footprint that allows us to offer members variety in terms of location, cost and amenities. 

Upside partners with the nation’s largest, traditional multifamily operators to offer older adults housing options that suit their lifestyle, budget and desired location. Then, we layer services as needed: meal delivery and preparation, transportation, daily engagement and health activities. 

Essentially, Upside can source housing for members in any given geography and also provide Social Determinants of Health (SDoH) concierge services through our Aging in Place specialists.

Housing is the Hub for Health 

Housing is the central point of our lives. It’s home base for a reason, touching everything from transportation to access to healthcare and meals. Housing also impacts healthcare coverage and benefits. 

When we look at the aging continuum, access to in-home support and services is a real challenge. When a trigger event like a fall, death, disaster, disability or divorce occurs, older adults can feel pushed into the traditional care model that limits choices and is cost-prohibitive for many populations. Ironically, scenarios like independent and assisted living, or nursing homes, can accelerate the aging process. This results in costly claims and erodes the value your members should realize from their health plan. 

Upside enables members to delay and even avoid costly moves to institutional care facilities by offering the support they need, where and when they need it. For health plans, this means improving health outcomes and reducing costly claims that contribute to escalating premiums. With Upside, health plans have a turnkey resource for members to transition into housing that is cost-effective and can include only the supports they need and want. 

Upside enables people to age in place. Not any place, the right place. 

Upside is a game changer – a brand-new, innovative housing model for adults who enjoy their independence and do not like the idea of a senior campus, set schedule, required meals and the stigma of senior living. 

With Upside, you give health plan members access to traditional housing in appealing locations with services that wrap around existing benefits.

  • You build a “house” of support by selecting Upside wrap-around services like food, transportation, and social engagement that address the SDoH factors impacting your member population and claims costs. 
  • We manage the details and provide a dedicated Upside Manager non-clinical concierge that engages with members to assure they maximize your offering.

The result: Satisfied members who have resources in place through your plan and Upside to age in place with better health outcomes.

An ROI Approach Delivers Value

Upside gathers data through our proprietary SDoH survey and tracks performance metrics through accrediting agencies like STAR, HEDIS, RAF/HCC, CAHPS/HOS and others. Data drives strategic decision-making for health plans. We are focused on continuous data gathering and analytics, offering real-time dashboards and reporting that can be integrated with electronic medical records. Upside’s offering for health plans is designed to impact the top and bottom line. Here’s how we do it: 

Reduce Costs

  • Manage high-risk members
  • Decrease hospitalizations and ER visits
  • Mitigate readmissions 

Improve Quality Matrices

  • Risk Scoring and HCC
  • Supplemental HEDIS data
  • Impact on STARS

Better Health Outcomes

  • Medication management 
  • Concierge non-clinical and Upside+ care management 
  • Support Medication Therapy Management (MTM) programs 

Member Retention and Satisfaction

  • CAHPS
  • Health outcomes survey 
  • Net Promoter Scores (NPS)
  • Member engagement 

*Upside is proud of our NPS rating of 95+

Support Your Plan Members’ Aging Journey 

With Upside, you can provide affordable, appealing housing in traditional communities and services that help keep your members healthy, active and engaged. Here is how we can support your members: 

  • Leverage our fully independent SDoH data and reporting to inform plan design.
  • Offer technology solutions and dedicated vendors to modify housing for members. 
  • Provide access to an Upside Manager to help members manage everyday tasks in their own homes
  • Provide access to suitable, healthy housing options – fully managed apartments with “Senior Living as a Service” solutions. 
  • Enhance coverage with skilled home care through Upside+
  • Offer matching, referral and transition support to members who need more care in assisted living or a nursing home.

We’re redefining what it means to age in place.

Join us on the journey and deliver the value your members are seeking as they navigate aging in place.

Upside Corporate Headqauarters

6365 NW 6TH Way, Suite 200

Fort Lauderdale, FL 33309