The Role of Population Health Management in Assisted Living
Proactive, timely care integrated with coordinated support services leads to longer, higher quality lives for seniors.
LaShuan Bethea
Executive Director, NCAL
3/10/2025
It is no surprise that our population is aging, and as we get older, the prevalence of chronic conditions increases.
The average age of an individual living in an assisted living community is 84 years. As adults age and manage more medical conditions, they increasingly seek options that emphasize health and wellness. It’s no longer just about living longer; the focus has shifted to living a long, high-quality life. A significant part of achieving this goal lies in integrating proactive, timely primary care and coordinated supportive services into daily living, a population health management approach.
Assisted living communities are ideally positioned to integrate the key components of a successful population health management program: data collection and analysis, preventative care strategies, and chronic disease management. In fact, many communities have already embraced this approach.
Population health management is built on a foundation of collaboration, communication, and coordination. To effectively provide person-centered care and services, assisted living communities must foster ongoing conversations among residents, their families, the assisted living support team, health care providers, and others to ensure that everyone involved is aligned and working toward the residents’ health and well-being. Establishing an environment where residents’ needs and preferences are the focal point not only enhances care outcomes but also significantly increases resident satisfaction.
Population health management focuses on improving health outcomes for a defined group of individuals. In this case, the group consists of individuals living and thriving in assisted living communities. Examples of health outcomes that can be managed include reducing hospital admissions, improving mobility and preventing falls, managing cognitive health and dementia, and enhancing nutrition.
Assisted living communities are increasingly leveraging artificial intelligence and electronic health records to monitor and proactively address residents’ health needs. For instance, wearables that track steps can help identify changes in physical activity, while temperature-monitoring devices enable early detection of illnesses. Gait and balance assessments are also commonly offered to identify and mitigate fall risks. Early detection of changes in conditions or function facilitates early intervention by the primary care team, mitigating the exacerbation of illness. These interventions exemplify how assisted living communities are becoming a prime setting for population health management.
In addition, many assisted living communities incorporate wellness programs, such as exercise classes, walking groups, social engagement activities, cognitive stimulation programs, vaccination clinics, and health education workshops. The integration of these wellness programs shifts the community’s focus from reacting to health declines to actively preventing them.
Ultimately, these early interventions and proactive health and wellness strategies reduce the need for costly treatments and hospitalizations. This combination of collaboration, communication, data-driven insights, preventive care, and a wellness-oriented approach results in an improved quality of life and better health outcomes for individuals in assisted living communities.
The American Health Care Association/National Center for Assisted Living offers population health management resources and will host the Population Health Management Summit on April 9-10, 2025, in Atlanta. Assisted living providers are encouraged to attend and learn more about the future of health care delivery and how population health management can bring lasting benefits to an organization. For more information and to register, please visit https://www.ahcancal.org/Education-Events/Population-Health-Management-Summit/Pages/default.aspx.
LaShuan Bethea is the executive director of the National Center for Assisted Living (NCAL).