Of the 99 largest metropolitan markets that the NIC MAP® Data Service (NIC MAP) tracks across the nation, 11 are located in California. Within these metropolitan markets, NIC tracks 870 seniors housing properties with 101,000 units, or nearly 12% of the seniors housing units regularly followed within the 99 markets by NIC. By coincidence, this share is comparable to California’s 12% share of the total U.S. population (38.8 million people live in California versus 320 million in the U.S. as of 2015). Within the state, performance measurements vary considerably.
Skilled nursing operators—and those who invest in the sector—are no strangers to challenges. Over the past few years, government, payor, and operator initiatives across the country have been working to create a new health care delivery and payment system, and these initiatives are expected to continue for the foreseeable future. In fact, some industry leaders suggest that it could be two years until we see a narrowing of networks and partner alignment that will expose the winners and potential losers of the emerging system.
David Gruber, MD, MBA, Director of Research and a Managing Director with Alvarez & Marsal Healthcare Industry Group, recently authored a timely, interesting, and provocative report entitled, “Post-acute Care: Disruptions (and Opportunities) Lurking Beneath the Surface.” The report provides a perspective on the rapidly aging U.S. population, the evolution of payment reform, and the implications of these changes on the post-acute care sector. Increasingly, payors, providers, and investors are being affected by the ongoing consolidation of hospitals, health systems, and physician practices, as well as the emergence of advanced payment models that are changing the competitive landscape among all post-acute care providers. The author writes: “With healthcare moving away from facility-centric reimbursement, the post-acute care sector is facing an inflection point that will produce clear ‘winners’ and ‘losers’. Our analysis is intended to help operators take the steps they need to stay competitive and continue serving patients, a necessity as the U.S. population ages and requires healthcare institutions that can meet a complex array of medical, behavioral, functional and social needs.”