Lynne KatzmannLynne Katzmann, PhD, chief executive officer, Juniper Companies, is excited about her organization’s future as the company she founded increasingly focuses on integrated seniors housing, co­ordinated care, and a full-fledged dive into the managed Medicare space as a member of a consortium preparing to sell medical insurance to residents.
In an interview with Provider, the veteran industry leader addresses the issues of the day in the seniors living and long term and post-acute care sectors. She also offers details on how Juniper fits into a marketplace that rewards nimble and fast-moving providers willing to take risks to drive growth and create new revenue streams.

An Eye Out For Opportunity

While Katzmann admits there are many challenges in serving seniors, she keeps the focus not on what ails the industry, but on the opportunities that exist. In doing so, Katzmann has made Juniper into a diversified leader with a strategic plan to make coordinated care, managed Medicare, and integrated seniors housing and care the bulwark of its future growth.

Based in Bloomfield, N.J., Juniper has 23 communities in four states: Colorado, Florida, New Jersey, and Pennsylvania. Within these properties the provider offers an array of services with assisted living or personal home care at its foundation, but also includes independent senior living, long term skilled care, memory care, respite services, senior campus living, and short-term rehabilitation.

Juniper also operates two partner companies: Juniper Design Group and Juniper Management. Through these sister subsidiaries, Katzmann says the organization shares its mission, values, and vision of aging beyond the traditional walls of being a provider to also reach out to the profession as a whole.
Provider: What is Juniper doing in the integrated care space?
Lynne Katzmann (LK): We are building and refining our integrated care program, Connect for Life, in preparation for extending the program to other industry operators. That is really exciting. The program has proven to have great results in reducing health care costs and increasing the quality of life and quality of care and services our residents receive. We decided as part of Juniper’s commitment to the industry we would share Connect for Life with other operating companies who are interested in the integrated care model, particularly as part of the Perennial Consortium, which is a consortium of operators who are banding together to start a provider-owned Medicare Advantage [MA] plan. So, that is pretty big.
Provider: What is Perennial all about?
LK: There are four founding members: Juniper; AllyAlign Health, which will manage the insurance plan; Christian Living Centers out of Denver; and Ohio Living out of Columbus, Ohio. We are also talking to many additional not-for-profit and for-profit providers who may join either as founding members or as follow-on members, at the joint venture or national entity level or at the state level. The focus is on operating as I-SNPs, C-SNPs, and potentially an MA plan. The insurance plans will go active on Jan. 1, 2021.
Provider: How big of a deal is this to be in MA space?
LK: There are many benefits to us. And, I believe to our industry segment. Some are qualitative rather than quantitative or financial. Qualitatively, MA offers our company and seniors housing in general the opportunity to showcase the positive impact we provide on quality of life. The services we provide enable us to manage lifestyles and prevent the exacerbation of chronic illness. In short, this allows us to provide preventive services, to positively impact not only quality of life but quality of care and overall cost of health care services.

This coincides with a growing recognition among those in the medical community as well as government policymakers that the prevention of chronic disease is paramount. Because of that new recognition of the value of services that we provide, MA offers us an opportunity to control the way those benefits are provided through service-enriched housing and to be a model for how the MA industry as a whole can work with seniors housing in the future.
Provider: Is there a quantitative part, too?
LK: Yes. Coordinated care extends length of stay, and enables us to find additional reimbursement for some of the services we already provide to an increasingly frail population.
Provider: What was the tipping point to get involved in managed care?
LK: We, at Juniper, are the driving force in getting the Perennial Consortium started. Many years ago we began to understand that under the Affordable Care Act providers were going to have to coordinate care and services for cohorts within Medicare. So, we began to look at care transitions and care coordination and realized that in our seniors housing and our systems we’re already doing that for the people in our buildings.

Care coordination eventually linked up with a whole host of ancillary service providers that we coordinate via electronic platform. What we found was that Connect for Life and its efficiencies and workflows had a huge impact on hospitalizations and readmissions. In fact, we had a third party look at our data, and they found that monetized nationally it would result in $10 to $15 billion in savings to Medicare for a similar group of beneficiaries around the country.

In the end, to truly capture all of our good work in care coordination and Connect for Life, the only way to do this was to become an MA insurer.
Provider: As you work toward the 2021 launch of Perennial, what have you learned?
LK:  For me the biggest thing was a recondition of our core competencies. We are in seniors housing and know how to operate well; we are not an insurance company. Running an insurance company takes a different set of skills, so we are partnering for that expertise through AllyAlign.

This was a critical decision, as it would have been more risky and time consuming to form our own third-party administrator. What will really make this work is that all of our partners are committed to implementing an integrated care model.

Provider: Do you have a sign-up goal in mind for the managed care offerings?
LK: That really depends on MA enrollment in each state and the program’s penetration among residents. But we would like at least 1,000 members in each state that we operate in for the first year and hopefully more.
Provider: Pulling back from managed care and coordinated care, what is your 30,000-foot view of where Juniper is focused as far as the type of care and communities you intend to operate?
LK: Taking a look at our portfolio, we think the future is in integrated housing—bringing together people in universally adapted housing, or in other words living in the same place but getting different levels of services. Down the road the need for stand-alone assisted living will change; the need for what skilled nursing provides will change. We see communities where people age in place in those communities.
Provider: Will the provider then be more outward facing as well?
LK: We see a huge shift from the traditional model for providing residents life and enrichment. We see resident life as all about creating an experience as we think about integrated care. Yet, we also believe strongly in fostering integrated experiences. This means people can have different experiences inside our buildings or outside our buildings and people can come from the outside and use our facilities.

For example, we renovated our CCRC [continuing care retirement community] in Bucks County [Pennsylvania], and now we have five eating venues, we have a center for healthy aging and an art center, and all of those spaces are designed to encourage the public to come in at appropriate times. It is all about the integration of our communities with the general community.