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 ones i in the P e PACE Model el Histor ory

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 omes 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 o 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 95% In Home & 42,000+ Participants Communities 76 A verage Participant Age 13

PACE b E by the Number ers - What 123 PACE 242 PACE Centers Organizations 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 organizations operate in 5 States 15

PACE b E by the Number ers Number er o of States es w with P PACE 35 32 32 31 31 31 31 29 30 25 20 15 10 5 0 JANUARY-12 JANUARY-13 JANUARY-14 JANUARY-15 JANUARY-16 JANUARY-17 JANUARY-18 16

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 of PACE Center ers [VALUE] 242 228 210 196 173 126 19

PACE b E by the Number ers Tren ends i in Number er o of PACE Partici cipants ts 50,000 45,000 [VALUE] 42,043 40,000 38,284 35,000 34,413 30,000 31,654 28,255 25,000 25,443 20,000 15,000 10,000 5,000 0 January-12 January-13 January-14 January-15 January-16 January-17 January-18 20

PACE b E by the Number ers Top op E Eight La Largest P t PACE P Prog ograms i in 2017 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 21

Wh Why Grow P w PAC ACE • 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.

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 programs:

Cu Curr rrent P t PACE P Prog ogram G Growth Between Jan. 1, 2013 – Jan. 1, 2017 the following states opened five or more new centers:

PACE C CE Census Gr Growth Between Jan. 1, 2013, and Jan. 1, 2017, the following states had their overall census numbers grow more than 50 percent

Qu Ques estion ons? Liz Parry, Senior Director, State Policy, NPA lizp@npaonline.org

Immanuel Pathways Council Bluffs, Iowa Immanuel Pathways Omaha, Nebraska Immanuel Pathways Des Moines, Iowa 27

PACE i E in Iowa Total N Number er o of Participants S Served ed i in I Iowa: 460 P 0 Participants 28

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% 29

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% 30

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 31

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 : 25 0 participants 32

Barri rriers t to o 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 33

QUESTIONS?