If you work in senior living, you’ve likely heard some version of this:

“By 2030, all Medicare beneficiaries will be in value-based care arrangements.”

That’s not speculative—it’s CMS policy. And while assisted living has historically operated outside of the traditional healthcare reimbursement system, that separation is narrowing fast. Medicare Advantage enrollment is climbing. Health systems are under pressure to reduce readmissions. And payers are increasingly accountable for total cost of care across the full continuum—including the time your residents spend in your buildings.

Whether you contract directly with these entities or not, you’re already in the value chain. That means your care practices, staffing models, and data—whether organized or not—are already influencing healthcare economics. The real question is: Are you capturing any of the value you create?

From Policy to Practice: Why VBC is an Operator’s Problem

Value-based care is often framed in regulatory or policy terms. But for operators, it’s fundamentally an operational issue.

It’s about whether your communities can:

• Proactively reduce avoidable hospitalizations
• Coordinate care across multiple providers and services
• Deliver consistent outcomes—then prove it with clean, credible data

None of that requires billing Medicare. However, it requires shifting from task-based care to outcome-based care, which is something that’s already happening in models like SNF-at-Home, PACE, and Medicare Advantage. Senior living is next.

The implications are real: hospitals are looking to reduce readmissions within 30 days of discharge, payers are analyzing total medical expenses, and care gaps are being scrutinized in ways that didn’t historically touch private-pay senior living. Communities that drive higher utilization risk losing future referrals. Those that reduce risk become reliable partners—exactly who hospitals and health plans want in their networks.

Operators who are operationally and technologically prepared? They’re earning leverage—with payers, with partners, and with families.

How the Best Operators Are Getting Ahead

While many communities are still figuring out where to start, others are already building infrastructure around value-based performance. And they’re not waiting for a contract to do it.

Here’s what they’re doing differently:

• They’re using internal data to identify risk—like rising call volumes, changes in mobility, or skipped meals
• They’ve stopped scheduling staff on fixed ratios, and started aligning labor with acuity
• They document care in formats external partners can actually use
• They’re forming relationships with payers and providers that lead to preferred partnerships

“Even if you are private-pay, even if you are only providing activities of daily living support—you are a strategic, important part of value-based care.”

— Christian Puff, Senior Legal Counsel, Humana, McKnight’s Senior Living

The shift isn’t abstract. It’s happening now—and the operators leaning in are already seeing better referral relationships, pilot opportunities, and revenue alignment models that didn’t exist five years ago.

A Different Kind of Accountability

Traditional accountability in senior living has focused on occupancy, compliance, and satisfaction surveys. VBC introduces a new layer: the ability to demonstrate your impact using data that healthcare partners recognize and trust.

That’s where many operators struggle—not because they’re not delivering great care, but because they can’t show it.

Forward-thinking teams are addressing that gap by:

• Surfacing trends in real-time—not waiting for monthly reviews
• Creating closed-loop workflows that document action, not just tasks
• Building dashboards that don’t just report activity, but identify opportunity

This kind of accountability means rethinking reporting. It’s not just about documenting that a call was responded to; it’s about capturing the time to claim, time to resolve, the resident’s condition, the outcome, and whether escalation was needed. These data points, when standardized and benchmarked, tell a much richer story about care quality.

This isn’t just about proving value externally. It’s about creating internal clarity on how care is being delivered, where breakdowns occur, and what success looks like.

What VBC Readiness Looks Like at the Community Level

So what does this look like in practice?

A resident’s fall, for example, may follow a pattern of small breakdowns: reduced mobility that went unflagged, delayed response times, missed hydration cues, or staff fatigue due to poor shift distribution.

A value-based approach requires communities to zoom out and see these events not in isolation, but as part of a larger operational ecosystem. It means identifying leading indicators, not just lagging ones—and equipping frontline staff with the visibility and workflows to act.

On the staffing side, it means moving from static, blanket scheduling to models that reflect real-time acuity. That’s not just good labor management—it’s fundamental to risk mitigation and performance under value-based frameworks.

This isn’t about replicating hospital-level care. It’s about knowing your data, using it to guide decisions, and aligning your team with the outcomes that matter most.

The Advantage of Not Waiting

Value-based care isn’t yet a requirement for assisted living, but that’s precisely why now is the time to act. Operators who move early have the advantage of shaping their own approach—on their own terms—rather than retrofitting a model designed for someone else.

The shift toward outcomes, data transparency, and care coordination is already influencing how communities are evaluated by families, referral partners, and payers alike. Those who treat this as an opportunity, rather than an obligation, will be better positioned to lead, partner, and grow in a changing landscape.

Becoming value-based isn’t about checking a box. It’s about proving what good operators have always known: when care is consistent, visible, and thoughtful, better outcomes follow.