PACE i CE in Iowa Liz P Parr rry Nati tional P PACE Associati - - PowerPoint PPT Presentation

PACE i CE in Iowa

Liz P Parr rry Nati tional P PACE Associati tion

PACE 101 101

What i t is PACE? E?

Seeing PACE Firsthand

What i t is PACE? E?

• Comprehensive
• Community Based
• Coordinated
• Capitated

Who ho Do Does s PACE S E Serve?

• 55 and older
• At a Nursing Home Level of Care
• Able to live in Community, with PACE services

Miles eston

• nes i

in the P e PACE Model el Histor

• ry

How D Does es P PACE Op Oper erate? e?

• PACE Center
• Primary Care
• Rehabilitative Care
• Activities
• Meals
• In the Home
• Transportation
• Contracted Network:
• Specialists
• Hospitals
• Assisted Living
• Other

Integ egrated ed Ser ervice De Delivery and T nd Team M Managed C d Care

Ou Outcom

• mes

es

• Better care
• Fewer unmet needs
• Improved chronic care management
• Better functional support
• Longer life
• Higher Quality of Life

PACE C E Costs ts

• Reduces high cost of uncoordinated care
• Fewer hospitalizations
• Less ER use
• Capitated = Predictable
• PACE rate less than current Medicaid cost
• No copays

Who

• Pays f

for PACE CE C Care

• PACE is a financially capitated program
• Organizations receive a per member, per month payment

to deliver all the necessary care

• Breakdown of Participants
• 90% dually eligible for Medicaid and Medicare
• 9% Medicaid-only
• 1% private pay, Medicare-only, other

PACE b E by the Number ers - Who

42,000+ Participants

95% In Home &

Communities

76 Average Participant Age

13

PACE b E by the Number ers - What

123 PACE

Organizations

242 PACE Centers

11 Average # Years

Programs in Operation

14

PACE b E by the Number ers - Where re

31 PACE States

19 Operate in Rural Areas

49% of all PACE

• rganizations operate in 5 States

15

PACE b E by the Number ers

Number er o

• f States

es w with P PACE

16 5 10 15 20 25 30 35 JANUARY-12 JANUARY-13 JANUARY-14 JANUARY-15 JANUARY-16 JANUARY-17 JANUARY-18

29 31 31 32 32 31 31

PACE b E by the Number ers

Number o r of PACE O Organ anizations b by State

17

PACE b E by the Number ers

Wher ere i e is PACE

18

PACE b E by the Number ers

Tren ends i in Number er o

• f PACE Center

ers

19

126 173 196 210 228 242 [VALUE]

PACE b E by the Number ers

Tren ends i in Number er o

• f PACE Partici

cipants ts

20 25,443 28,255 31,654 34,413 38,284 42,043 [VALUE] 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 January-12 January-13 January-14 January-15 January-16 January-17 January-18

PACE b E by the Number ers

Top

• p E

Eight La Largest P t PACE P Prog

• grams i

in 2017

21

PACE Organization Name State Census CenterLight Health Care NY 3282 InnovAge of Greater Colorado CO 2667 AltaMed Buena SeniorCare CA 2147 On Lok Lifeways CA 1439 Providence ElderPlace - Portland OR 1268 Summit ElderCare MA 1155 Element Care MA 954 Bienvivir All-Inclusive TX 927

• Delivery system reform – fully realized
• Integrated (Medicare/Medicaid; Acute/Primary/LTSS)
• Community based
• Person centered, provider-sponsored
• Value
• Below states’ cost of serving a comparable population – 16%
• Predictable, capitated cost to states
• Quality
• Increased life expectancy 1
• Improved physical and mental functioning 1
• Higher quality of life 1
• Longer ability to live at home 2

1

Wieland, D., Boland, R., Baskins, J., Kinosian, B. (2010). Five-year survival in a Program of All-Inclusive Care for the Elderly compared with alternative institutional and home- and community-based care. J Gerontol A Biol Sci Med Sci. July: 65 (7), pp. 721-726.

2

Segelman, M., Cai, X, van Reenen, Temkin-Greener, H. Transitioning From Community-Based to Institutional Long-term Care: Comparing 1915(c) Waiver and PACE Enrollees. The Gerontologist 2015.

Wh Why Grow P w PAC ACE

Between Jan. 1, 2013 – Jan. 1, 2017 the following states opened five or more new programs:

New P PACE CE P Progr gram am Gr Growth

Between Jan. 1, 2013 – Jan. 1, 2017 the following states opened five or more new centers:

Cu Curr rrent P t PACE P Prog

• gram G

Growth

Between Jan. 1, 2013, and Jan. 1, 2017, the following states had their

• verall census numbers grow more than 50 percent

PACE C CE Census Gr Growth

Qu Ques estion

• ns?

Liz Parry, Senior Director, State Policy, NPA lizp@npaonline.org

27

Immanuel Pathways Council Bluffs, Iowa Immanuel Pathways Omaha, Nebraska Immanuel Pathways Des Moines, Iowa

28

PACE i E in Iowa

Total N Number er o

• f Participants S

Served ed i in I Iowa: 460 P 0 Participants

29

What Does the Immanuel Pathways PACE Population Look Like?

Central Iowa Southwest Iowa Average Age 67 72 Min 55 56 Max 94 97 Percent Female 64% 54% Independent Living 87% 82%

30

What Does the Immanuel Pathways PACE Population Look Like?

Central Iowa Southwest Iowa Dual 110 96% 150 94% Medicare Only 1 1% 3 2% Medicaid Only 4 3% 6 4%

31

Imman anuel P Pathways S Southwest I Iowa a

Location: Council Bluffs, IA Opening D g Date te: January 2012 Servi vice A e Area: Mills, Pottawattamie, and Harrison Counties Enrollment: t: 159 participants (20% saturation) 55-64: 25% 65+: 75% Center er C Capa pacity: 230-240 participants

32

Imman anuel P Pathways C Central al Iowa

Location: Windsor Heights, IA Opening D g Date te: October 2015 Servi vice A e Area: Boone, Dallas, Jasper, Madison, Marion, Marshall, Polk, Story and Warren counties Enrollment: t: 115 participants (3% saturation) 55-64: 54% 65+: 46% Center er C Capa pacity: 250 participants

33

Barri rriers t to

• growin

ing PACE

• Cut-off dates for Enrollment into program
• Awareness in the state
• MCOs reluctant to refer individuals with high needs to

PACE

• Expansion of PACE program
• Capital needed to start program
• Iowa good partner and always willing to have

conversation

QUESTIONS?