Older Adults Benefit When Health Care Providers and Affordable Housing Sites Partner

A new study in the journal Health Services Research shows lower hospitalization rates, days, payments, and readmissions for residents participating in Hebrew SeniorLife’s R3 program.

BOSTON – Older adults benefit from enhanced partnerships between health care systems and affordable housing sites. These partnerships improve health care outcomes while reducing unnecessary spending and/or use, according to research published in the Health Services Research journal.  

The effect of the Right Care, Right Place, Right Time (R3) initiative on Medicare health service use among older affordable housing residents” study was designed to evaluate the R3 program of Hebrew SeniorLife, a Harvard Medical School-affiliated nonprofit. The report was coauthored by Tavares, J. Simpson, L. Miller, EA, Nadash, P. and Cohen, M. of the LeadingAge LTSS Center @UMass Boston.

Seniors living in sites with the R3 program had lower hospitalization rates, days, payments and readmissions than residents living in similar control sites.  This is the first study to document a decline in 30-day re-hospitalization rates among low-income senior housing residents who have access to place-based wellness teams, when compared to low-income seniors in buildings without this level of support.

R3 embeds a wellness nurse and coordinator in senior housing.  The place-based team efficiently conducts assessments and routine proactive check-in calls, risk stratifies the population based on established key risk factors, puts services in place to meet needs, partners with organizations to strengthen care coordination and communication, and tracks/trends data to drive and monitor results.

Hebrew SeniorLife developed R3 to address the disconnect between housing and health systems in order to improve the health and wellbeing of seniors. Partners, including emergency responders, health plans, area agencies on aging, and government agencies, were able to leverage congregate senior housing to achieve positive outcomes. 

The research sought to determine the effect of this housing-based intervention on Medicare health service use among senior housing residents. R3 enrolled 400 participants across seven intervention sites, four operated by Hebrew SeniorLife and three operated by partner providers, including Milton Residences for the Elderly and WinnCompanies.

Program Impact

Researchers noted that: “The findings suggest that the combined focus on assessment, proactive outreach, and prevention (with special attention to high-risk individuals); coordination with off-site providers; and the strengthening of an ‘eyes-on’ culture, led to the positive results.”

“Both the comprehensive quantitative and qualitative analyses that we have undertaken demonstrate conclusively that the program is having a major and positive effect on residents and that health care payers also benefit from lower health care costs by having their members participate in the program,” said Marc A. Cohen, Co-Director of the LeadingAge LTSS Center at UMass Boston.  “The R3 program hits all success metrics.”

“This research demonstrates that R3 delivers much-needed health and quality-of-life improvements for residents of senior housing,” said Louis J. Woolf, president and CEO of Hebrew SeniorLife. “At the same time, R3 contributes to efforts that avoid unnecessary care and reduce costs for a system that is beset with labor challenges and struggling to provide both sufficient and affordable services.  We are encouraged by the fact that with this data, policy makers are giving serious consideration to the benefit of adopting R3-like programs across the Commonwealth.”

Researchers concluded: “Age-friendly health systems would do well to enhance partnerships with affordable housing sites to improve care and reduce service use for older residents.”

Funding and Recognition
This study was funded, in part, by Hebrew SeniorLife, which designed and piloted the R3 program and secured additional funding for the evaluation and intervention. Funders include the Massachusetts Health Policy Commission Health Care Innovation Investment and SHIFT Care Programs, Beacon Communities LLC, Boston Scientific Foundation, Coverys Community Healthcare Foundation, Enterprise Community Partners, Massachusetts Department of Housing and Community Development, and MassHousing.  

The Pioneer Institute 2017 Better Government Competition honored R3 with its Grand Prize and the John A. Hartford Foundation honored R3 with its 2021 Business Innovation Award.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, was founded in 1903 and today is a national leader dedicated to empowering seniors to live their best lives. Hebrew SeniorLife cares for more than 3,000 seniors a day across six campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline; and Jack Satter House, Revere. Hebrew SeniorLife also trains more than 1,000 future health care professionals each year, and conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a robust research portfolio whose NIH funding in 2021 places it in the top 10% of NIH-funded institutions. For more information about Hebrew SeniorLife, visit our website or follow us on our blog, Facebook, Instagram, Twitter, and LinkedIn.

About LeadingAge LTSS
The LeadingAge LTSS Center @UMass Boston conducts research to help our nation address the challenges and seize the opportunities associated with a growing older population.  The LTSS Center is the first organization of its kind to combine the resources of a major research university with the expertise and experience of applied researchers working with providers of long-term services and supports (LTSS).