Lifespark, National Church Residences See ‘lead Or Follow’ Moment For Health Care In Senior Living

The senior living industry stands at the precipice of a big opportunity in health care – if they are bold enough to realize it and take action.

Providers face growing pressure to shift from fee-for-service models toward value-based care arrangements as the Centers for Medicare and Medicaid Services (CMS) aims for all Medicare beneficiaries to be in accountable care organization (ACO) arrangements by 2030.

For more than a decade, industry stakeholders have positioned value-based care as the inevitable future of healthcare reimbursement. Hospitals and insurers have been in the driver’s seat with regard to that future, but they have not always done well. Now, senior living stands a chance to take the wheel.

Providers in the space face a critical choice: participate in emerging value-based care models or be left out of benefiting from the value they create in improving the lives of older adults through preventative health care services, life enrichment and wellness efforts.

“Within the next three to five years, somebody is going to have actuarial risk for the Medicare spending of your residents, a hospital, a physician group, an ACO—someone,” said ATI Advisory CEO Anne Tumlinson during a 2026 Spring NIC panel on value-based care.

Who drives the value-based care ‘car’ matters in 2026

Historically, CMS has given the keys of the proverbial value-based care vehicle to hospitals and large health insurance plans, according to Lifespark CEO Joel Theisen. But hospitals historically excel in acute care or “sickness care” and asking them to lead health and prevention spurred misalignment from the get-go.

“They drove the car into the ditch,” Theisen said during the NIC panel due to high costs and limited success in transforming care without shifting toward preventative care.

CMS then turned to large health plans and Medicare Advantage (MA) insurers because “they don’t know where else to put it,” Theisen said. Insurers were expected to “muscle” value-based care efforts but they too “drove the car into the ditch.”

Now, senior living operators have an opportunity to both improve their services and reap some of the financial outcome. It’s a kind of “lead or follow” moment, he said.

St. Louis Park, Minnesota-based senior living provider Lifespark operates a model called Lifespark Complete, which assumes risk for patient outcomes. The program features a “complete life record” that spans primary care, home health and hospice services in addition to a newly introduced in-home urgent care and emergency response team.

Lifespark Complete Senior Living brings together four “key components” within the company’s capabilities—senior living property management, activities and wellness programming led by Lifespark Chief Independence Officer Dr. Bill Thomas, medical services and hospice services—into a unified platform.

As Theisen sees it, senior living providers are in a unique position due to the intimate relationships they create in communities, understanding resident habits, preferences and health needs.

“You know their love, you know their families,” Theisen said. “Who in the hell do they want to give the keys to? Do you want to let them come and eat your lunch and have it, it’s going to happen.”

It’s an approach that has driven outcomes for Lifespark. The organization’s average occupancy is in the 90th percentile and all of its buildings carry net operating income margins (NOI) of at least 30%.

Theisen estimated that senior living operators can earn, on average, $500 per plan member per month taking a similar approach. And that is money that will change hands, whether operators chase it or not.

“This is about changing the game, changing the experience for residents and families and creating something that’s really beautiful and not driven by acute care,” he said.

How new models impact value-based care adoption

In recent years, senior living providers have been in an “arms race” when it comes to value-based care growth. Some view the future of assisted living positioned squarely within these boundaries of value-based care.

Tumlinson said the “surge” in new payment and service delivery models from the CMS Innovation Center is an opportunity for companies to participate in getting reimbursed by Medicare or Medicaid programs in different ways.

This “surge” means that more groups will be “playing in our sandbox” that will “inject accelerant” into what Tumlinson termed as a “land grab” by health care companies for access to senior living residents. The impact could have implications on senior living property valuations based on how well providers are “prepared and engaged” in the growing value-based care ecosystem. All of this centers on the prevention and management of chronic illnesses.

“I would characterize these models, the way they designed these models as they have injected them with a lot more power,” Tumlinson said. “They’re making the models more predictable, giving investors more predictability and more lead time.”

This is in the name of allowing smaller providers to have an opportunity to participate in value-based arrangements as opposed to large health systems and physician groups having all the access, Tumlinson said. With more flexibility in the new models, it will enable CMS to cover things Medicare historically did not cover in the past, specifically in preventing disease to reduce health care spending.

For example, the Long-term Enhanced ACO Design (LEAD) model adds benchmarking and risk adjustment to reach a broader mix of health care providers. The model establishes a 10-year framework known as a performance period without rebasing to provide a pathway toward “sustainable, long-term benchmarks and savings,” according to CMS. Through LEAD, this creates a “new version” of ACOs.

In 2023, National Church Residences launched home-based primary care services to over 10,000 older adults living in 190 communities to prevent hospitalizations and associated high-cost medical events.

A typical hospital stay costs approximately $14,000 followed by a stint in skilled nursing that could cost $12,000 and later certified home health services for 60 days totaling approximately $4,000, according to National Church Residences Vice President of Strategic Growth and Operations Support Jacob Swint.

National Church Residences pursued this to move past post-acute care to pre-acute care efforts to “stop reacting” to acute health outcomes and become proactive in preventative health.

Through the Medicare Shared Savings Program (MSSP) and ACOs, National Church Residences has reported savings of approximately $10,000 per resident annually. CMS keeps 25% of the sum and the remaining is split among the ACO, medical group and National Church Residences, Swint said. But the senior living industry can and should take a more prominent role in that exchange.

“Senior living organizations did a lot of work to generate that $10,000 in savings, yet we’re not pulling up a seat to the table as an industry to ask for a portion of those savings,” he said.

Reaping the benefits of the outcomes senior living providers create is vital to improving the value proposition of senior living since communities monitor residents daily, support preventative health and provide care coordination efforts.

Through the organization’s efforts, the organization has demonstrated that senior living providers can become the core care partners in health care delivery, generating savings while improving outcomes.

“How do we stop that vicious cycle from taking place as many times as it does?” Swint said. “With our resident base, that’s what we have to figure out.”

While a small number of ACOs focus on senior living, Swint said it’s up to operators to branch out and start on their own value-based care journey despite the challenges in scaling models. To work around those challenges, Swint said operators must partner together with providers in the space with experience in value-based care.

“Go find a partner that already knows what they’re doing,” Swint said. “This is the highest return that gives you the best results.”

Theisen said the time is now for senior living providers to get in the value-based care arena or risk missing out and having health providers “screwing up your workflow,” while gaining greater control of the health benefits providers work hard to create.

“This is not fantasy land anymore. This is real stuff. There’s real opportunity, there’s real structure,” Theisen said. “So get somebody and people that know what they’re doing, have you integrate that into your buildings.”

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