Oct 29, 2020
I made my way past the floor-to-ceiling bay windows and paused at the French doors, which led to the terrace of my dream home. That’s when a “low battery” message on my phone snapped me back to my own personal reality — a couch in my 1.5 bedroom Manhattan apartment.
Even though I have no plans to move, all the time I’ve spent indoors over the past several months has led me to develop a new hobby: “Zillowing.” And I’m certainly not alone, as there are many others like me who have become a Zillow 3D Home Tour power user.
A wave of innovation in home search tools has been driven by recent improvements in 3D-imaging. These technologies have played a role in my new-found interest in “Zillowing,” which reflect a unique combination of tech advancements, a desire for escapism, and a fairly liberal definition of “fun” during the pandemic.
I’ve been surprised and thrilled to find business models and technologies still ripe for innovation. Senior housing, for example, lacks basic search tools, fintech products, or services that have been widely adopted in other industries. However, the senior housing market seems to be at the cusp of transformation as the target market changes. On a macro level, the global pandemic and recent innovation in the payments industry have brought more attention to senior housing.
As such, prospective owners and operators will recognize this as a unique moment to help define the future of senior housing while staking their place in it, too.
There are more than 50 startups that will help you renovate a guest bathroom. And yet, new companies continue to enter the $400 billion home renovation industry. For those who can’t read enough about bathroom trends, Googling “home improvement bathroom trends 2020” will return roughly 54.9 million results. By comparison, a search for “senior housing comparison tools” returns only a handful of outdated websites.
This begs the question: Why is it easy to find a dream toilet, but still so difficult to compare the quality and cost of senior housing options for an aging parent?
Senior housing is a large, diverse market sitting at the intersection of multifamily housing, health care, and hospitality. The U.S. senior housing market is a $420 billion industry, and represents approximately 3 million beds spanning a spectrum of housing types. As Baby Boomers enter their golden years, the market will experience further growth — representing a large population size, many with considerable wealth, and a familiarity with technology unlike previous generations.
Much to the chagrin of Gen Xers and millennials, Baby Boomers will undeniably be the wealthiest and most tech-savvy cohort of senior living residents in history. However, financial flexibility and tech adoption among older adults may prolong their independence, delaying transitions to senior housing. However, models like Continuing Care Retirement Communities (CCRCs) offer scalable services that enable long term viability as a resident’s acuity changes over time. These concepts, along with other models that “unbundle” services, seem to resonate with a generation increasingly focused on wellness and active lifestyles.
In the venture capital world, timing is everything. According to CBInsights, mistimed product launches account for approximately 13% of failed startups; sometimes, the world just isn’t ready for a new product or service. Moreover, just like other B2B markets, commercial real estate is often slow to adapt to new technologies, and typically embraces digital trends a few years after the residential market.
The senior housing industry, on the other hand, has been ahead of the curve. Smartphone adoption among seniors was up 400% between 2011 and 2016, as the world of search, discovery, and fintech tools has rapidly evolved for the residential and hospitality sectors. Coupled with the compelling demographic trends ahead, this dynamic has positioned senior housing as one of the next markets for PropTech proliferation.
But then came the Coronavirus pandemic, and the attention placed on nursing home outbreaks as they became hallmarks of the crisis. While the PropTech industry has had a difficult time since the start of the pandemic — with notable dips in occupancy, labor supply, and M&A activity — the long-term outlook remains positive. The pandemic dented consumer perception momentarily, but general opinions have remained, effectively, unchanged.
In the senior housing market, transparency — particularly around pricing — is still very limited. The range of pricing and financing options across facility types is expected to widen as the “unbundling” of services becomes more common. In recent years, the average annual costs to live in an assisted living facility were just shy of $45,000, whereas a private room in a nursing home could cost more than $90,000, according to data from the insurance company Genworth.
The lack of pricing transparency has, traditionally, been due to the personalized service levels and needs of each resident. Because each resident is different, it’s difficult to show a simple, accurate pricing model like you’d see in other markets. However, increased pricing transparency is shown to improve commercial results, according to Genworth’s data, which looked at 4 million senior living website visitors. In other words, those who were shown pricing or financial information were significantly more likely to convert to a resident.
In short, there is palpable demand for both transparent pricing and affordability solutions. Both concepts are beginning to pick up steam, including new programs launched by the Centers for Medicare & Medicaid Services (CMS) and other insurance providers in coming years.
But a wide range of financing options with varying availability to seniors and family members add to the complexity. Financial solutions include Social Security, CMS programs like Medicare Advantage (MA), long-term care insurance, tax benefits, mortgage-linked products, and other loan-based solutions. Each option comes with a set of limitations and drawbacks, including ineligibility, prohibitive costs, and even bankruptcy risk. In fact, more than half of middle-income seniors may not be able to pay for private housing by 2029. Thankfully, such concerns have not gone unnoticed.
Recent indications from CMS have pointed toward upcoming payment model innovations from the MA program. The industry has mixed views on the levels of commitment and effectiveness of future policy changes, but the MA program, overall, is expected to continue growing rapidly.
In 2019, CMS first allowed MA plans to cover certain non-skilled, in-home care, indicating a potential path to reimbursement of providers for certain historically out-of-pocket services. Although still early, the expansion of supplemental benefits is being closely monitored, as are new programs like Medicare Advantage Special Needs Plans (SNPs), which are among the most promising current senior living trends. SNPs restrict enrollment to specific beneficiaries like assisted living residents, and work with medical providers who coordinate care and on-site visits, eliminating transportation needs associated with doctor visits.
Although it may not lead to direct, large-scale changes, CMS policy may be broadly catalyzing innovation activities. For example, Aetna has begun offering a referral service as a MA benefit, highlighting unmet demand for search and discovery solutions. Other early movers include Welltower’s partnership with Anthem and its affiliate CareMore, which offers on-site services. Given the collaborative nature and shared services required, these types of programs will need a significant level of resident enrollment to ensure their financial and operational viability. As such, new opportunities for financial innovation and tech solutions are likely to emerge around new incentives structures.
While “Zillowing” for senior housing is still a ways away, interest is growing as tech-savvy generations are approaching their golden years. If the trajectory of digitization resembles that of other, similar industries, parodies of seniors and technology will quickly become outdated.
Jeanne Casey is a principal at MetaProp
This article was originally published in GlobeSt.com.