『Perspectives in Long Term Care』のカバーアート

Perspectives in Long Term Care

Perspectives in Long Term Care

著者： American Health Care Association
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An original podcast series produced by the American Health Care Association and the National Center for Assisted Living, created specifically for leaders in the long term and post-acute care profession.Copyright 2023. American Health Care Association. All rights reserved. マネジメント マネジメント・リーダーシップ 経済学 衛生・健康的な生活
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  • Wellness First: Building a Value-Based Care Model

    Wellness First: Building a Value-Based Care Model
    2026/09/09
    In this episode, host Debbie Stadtler welcomes Irene Borgen, PhD, MBA, MSN, MJ, FACHE, RN, vice president of innovation and clinical partnerships at Sunrise Senior Living, for a conversation about why value-based care represents an important inflection point for assisted living. Irene explains how the shift from fee-for-service to outcomes-focused care aligns with Sunrise’s wellness-first approach and the evolving expectations of residents and families. She shares how Sunrise established baseline measures around hospitalizations, emergency room visits, readmissions, falls, polypharmacy and satisfaction before developing a relationship-based model that brings clinical partners into communities while preserving residents’ choice of primary care provider. The conversation explores the realities of implementing this model, from change management and team training to consistent measurement and selecting the right partners. Irene also discusses how value-based care can benefit residents and families while strengthening care teams, referral relationships and business outcomes such as occupancy and retention. Perspectives in Long Term Care is produced by Association Briefings. Transcript Debbie Stadtler: Superior clinical outcomes for residents, increased family trust, and better metrics for your facility? That's the promise of value-based care in assisted living. Learn how to get started with Irene Borgen in this episode of Perspectives in Long-Term Care. Hi, I'm Debbie Stadtler, editor-in-chief of Provider Magazine, the flagship publication of the American Health Care Association and the National Center for Assisted Living. I'd like to welcome you to this episode of Perspectives in Long-Term Care, a monthly podcast produced by AHCA and NCAL. Each month, we'll talk with long-term care and assisted living professionals about the opportunities and challenges impacting the long-term and post-acute care profession. My guest today is Irene Borgan. Irene serves as vice president of innovation and clinical partnerships at Sunrise Senior Living. She is a registered nurse, a licensed nursing home administrator, a board-certified nurse executive, a certified professional in health care quality, and a fellow of the American College of Health Care Executives. Welcome, Irene. Thanks for being with us. Irene Borgen: Thank you, Debbie. Thank you so much for having me. Debbie Stadtler: Well, let's start at the beginning. Tell us about your career journey. What led you to get started in long-term care? Irene Borgen: I joined Sunrise just over three years ago after spending more than two decades in the broader health care industry. I started my career as a clinician and gradually moved into hospital administration and executive leadership with an increased focus on operations, quality and safety, care transformation, population health, and most recently, value-based care. Over the years, I've worked across hospital, home care, skilled nursing, ambulatory, and health insurance settings, and have been very fortunate to bring that experience with me to Sunrise. Today, I have the opportunity to help advance Sunrise's strategy around innovation and clinical partnerships, and to think about how we can apply value-based care principles within senior living while continuing to strengthen our person-centric holistic approach to wellness. Debbie Stadtler: So Irene, tell me about your organization. When did value-based care first come onto your organization's radar, and what made you realize this was something that assisted living could not afford to ignore? Irene Borgen: Let me start with a bit about us and how this fits in a much bigger ship. Sunrise is one of the largest senior living operators in the US with some communities in Canada. We have around 240 communities currently. We offer independent living, assisted living, some skilled nursing, and are serving around 20,000 residents. Wow. And we've always been an organization focused on hospitality and wellness. That's in our DNA, and it's the promise we make to residents and families. But I would frame the value-based care itself as bigger than one company's decision. It's an industry-wide inflection point. Since the introduction of the Accountable Care Act in 2010, also known as Obamacare, the US health system has been shifting from paying for volume, also called fee-for-service To paying for quality and improved health care outcomes. And that shift continues to reshape every care setting, including senior living. In other words, value-based care movement aims to help people stay healthier longer, prevent unnecessary hospitalizations, improve overall health care outcomes, and contain escalating health care costs. And senior living is really uniquely positioned in that shift. Our teams don't just provide services, they truly know our residents. They notice when someone isn't quite themself, whether it's a change in appetite, energy level, participation in ...
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    21 分
  • Keeping Pace with a Changing Reimbursement Landscape

    Keeping Pace with a Changing Reimbursement Landscape
    2026/08/13
    In this episode, host Debbie Stadtler welcomes John Kane, senior vice president of reimbursement policy at AHCA/NCAL, to discuss how reimbursement policy directly impacts the resources providers have to deliver quality care and the challenge of keeping pace with an ever-changing policy landscape. Kane explores the development of the Patient-Driven Payment Model (PDPM), its shift from volume-based reimbursement to a model centered on patient characteristics, and the challenges states face when adapting PDPM for Medicaid populations. He also examines major Medicaid changes under H.R. 1, ongoing Medicare Advantage challenges related to access and payment, and the growing regulatory demands facing facilities. The conversation highlights why staying informed and engaged is increasingly important as reimbursement continues to evolve toward value-based care. Perspectives in Long Term Care is produced by Association Briefings. Transcript Debbie Stadtler: Hi, I'm Debbie Stadtler, editor-in-chief of Provider Magazine, the flagship publication of the American Health Care Association and the National Center for Assisted Living. I'd like to welcome you to this episode of Perspectives in Long term Care, a monthly podcast produced by AHCA and NCAL. Each month, we'll talk with long term care and assisted living professionals about the opportunities and challenges impacting the long term and post-acute care profession. My guest today is John Kane. John is the senior vice president of reimbursement policy at AHCA and NCAL. Prior to this, he spent almost 15 years at the Centers for Medicare and Medicaid Services. Welcome, John. Thanks for being with us. John Kane: Thank you very much, Debbie. It's a pleasure to be here. Debbie Stadtler: We like to start at the beginning. So tell us how you got involved in long term care. How did your career lead you to where you are today? John Kane: A combination of things probably. I think one part of the journey started back years ago when I was studying philosophy of all things... and had every intention of becoming a college professor: teaching, publishing, sipping wine. And but I found that as I was talking with my colleagues, and I would be asking questions that they didn't seem to really care much about. We would be talking about health policy, and I would ask questions like, "Well, how are we gonna pay for that?" Or "How are providers going to implement this?" And they didn't really seem to care, and I realized at that point I wanted to do something that was more applied and less theoretical. And at the same time, as a matter of coincidence, I was actually working at a facility in Blacksburg, Virginia, Five Stars Warm Hearth, shout out. Nothing glamorous but very important role. I worked in the kitchen. And I'll tell you that trying to make a soft liquid diet palatable takes a lot of skill. But my experience there also helped me to see the daily struggle of the people that were working in that industry and the amount of passion that they brought to it and really just dedicating their lives to valuing the lives of seniors. And I loved being a part of it, even a small part. And as I was there, I felt like there was more that I could do, and I wanted to get deeper into it. And so that eventually led me into the deeper areas of health policy and eventually led me to CMS. Debbie Stadtler: I love that story. A little hands-on kitchen experience really leads you to your greater purpose in health policy and helping those in long term care. I love that story. John Kane: I like to think that I've done more not burning people's food than- Debbie Stadtler: Always important. Your background includes years spent working at the Centers for Medicare and Medicaid Services, what we know as CMS. What's that like working on the government side of reimbursement, and how did that time kind of influence your views? John Kane: My time at CMS was some of the most formative and memorable time of my life, especially my career. I can't speak highly enough about the people that I worked with at CMS and that continue to work within CMS. They are dedicated public servants, all of them, and it was also just an incredible feeling to be at the genesis of policy development. It was hard to not feel as though you were doing something that was impactful and you were making a difference every day. At the same time, I also felt a certain disconnection from the industry that I had grown to love. I would go to visit facilities, whether it was because my dad was in a facility or just to get back out in the field and go and visit with residents or visit into the various homes, and it felt different. I was no longer just a person walking through the halls. I was CMS now. And so conversations became more focused on policy than on people, and I missed it. And moreover, I think being at CMS, you develop a level of specialization that is nurtured by the, the siloed nature of the agency. While I was there, ...
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    23 分
  • Reflecting on the Past, Preparing for the Future

    Reflecting on the Past, Preparing for the Future
    2026/07/14
    In this episode, host Debbie Stadtler welcomes James Carlson, senior reimbursement advisor at AHCA/NCAL, and Nicolette Reilly, senior vice president of quality at the Oregon Health Care Association, for a conversation about the evolution of assisted living over the past four decades. They reflect on the origins of the assisted living model, how the definition of quality has expanded to focus on resident experience and continuous improvement, and the balance between regulation and innovation. The discussion also explores the role of NCAL in advancing the profession and looks ahead to the future of assisted living, including emerging technologies, workforce development, personalized care, and changing consumer expectations. Perspectives in Long Term Care is produced by Association Briefings. Transcript Debbie Stadtler: Since its inception in the 1980s, assisted living has used innovation to redesign aging. Hear more about the evolution of assisted living, how quality has matured, and why the next 25 years may be the best yet. Hi, I'm Debbie Stadtler, editor-in-chief of Provider Magazine, the flagship publication of the American Health Care Association and the National Center for Assisted Living. I'd like to welcome you to this episode of Perspectives in Long Term Care, a monthly podcast produced by AHCA and NCAL. Each month, we'll talk with long term care and assisted living professionals about the opportunities and challenges impacting the long term and post-acute care profession. My guests today are Jim Carlson and Nicolette Reilly. Jim is a senior reimbursement advisor at AHCA/NCAL, and he spent 30 years with the Oregon Health care Association, including 23 years as the CEO. Nicolette is the senior vice president of quality at the Oregon Health care Association. Welcome, Jim and Nicolette. Thanks for being with us. Jim Carlson: Good afternoon. Debbie Stadtler: Well, let's start at the beginning. Tell us about your career journey. What led you to get started in assisted living and long term care? Jim, do you want to kick us off there? Jim Carlson: Sure. I'd say probably my first interest really in health policy and all the issues related to Medicaid and Medicare and the economics and aging demographics was, I worked for an economics professor of mine in college when he ran for Congress. And we spent hours upon hours driving around the Fourth Congressional District in Oregon, and he had a particular interest in health care and health care economics. And since he was running for Congress, he had a particular interest in federal level issues, dealing with Medicaid and Medicare and health care economics. And so it piqued my interest. He ended up losing that race, but I ended up, after graduation, going to work for another member of Congress, and being low man on the totem pole on the staff, Medicaid and Medicare came into my portfolio. And so I really, from just a very young age, got very interested in federal health care finance and reimbursement programs and the economics, and I always had a real keen interest about demographics and the impact that had on the economy and society. Debbie Stadtler: Nicolette, how did you get started? Nicolette Reilly: My path was very different from Jim's. When I graduated with my undergraduate degree, I had a business minor, and right out of college, I started working as a finance and business office manager for a new assisted living in Fort Collins, Colorado. And as a very young, new into the profession, I never envisioned that my career would be in long term care. It just happened to be this door that opened up to me from a business perspective. So in 1995, I started out as a business office manager in an assisted living, and just over the years went from a business office manager to an assistant administrator to an administrator, and then to a regional ops person, and then a vice president of operations. Even did a stint as an owner/operator of an assisted living company a while back. And then about four or five years ago, really wanted to find a way to take my passion of working with seniors and take my passion around driving quality in long term care, and try and find different ways that I could engage and influence the quality that was happening in long term care and how to drive that. And so I had a great opportunity to come over to the Oregon Health Care Association, where now I've been able to see long term care from a completely different perspective, more from the legislative perspective and the regulatory perspective and what goes into that, and the wonderful opportunity to advocate on behalf of providers in both of those areas. Debbie Stadtler: That's interesting. So both of you come at assisted living from a different perspective than normal. Usually I hear about people have a family member that inspired them, or they start as a caregiver, a CNA, and things like that. But you guys really come from, like, the business economics perspectives, ...
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    33 分
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