As Executive Search Consultants specializing in the healthcare industry we very much like to stay in tune with what is happening in the marketplace. Each quarter we would like to feature an interview with key leaders who are working for organizations that are making an impact on how healthcare is being delivered. This quarter we are featuring an interview with Shawn Bloom,President and CEO of the National PACE Association. PACE stands for: Program of All-Inclusive Care for the Elderly. These organizations have been around since 1997 and we continue to hear about the effects the programs are having on the lives of the frail elderly. The National PACE Association (NPA) is a trade association that represents PACE nationally.
Shawn has been the president and CEO of NPA since 2000. He is responsible for the strategic direction, operational activities and overall performance of the association and leads state-related activities. Previously, Shawn was Executive Director of the Missouri Association of Homes for the Aging and worked in the Policy and Governmental Affairs Department at the American Association of Homes and Services for the Aging. He completed his undergrad degree in Pre-Med, but then got the “healthcare policy bug” and pursued policy roles for care of the aging throughout his career.
What is PACE?
“The Program of All-Inclusive Care for the Elderly (PACE®) is a comprehensive, fully integrated, provider based health plan for the frailest and costliest members of our society—those who require a nursing home level of care. The PACE philosophy is centered on the belief that it is better for frail individuals and their families to be served in the community whenever possible. Although all PACE participants are eligible for nursing home care, 95% continue to live at home. I would describe PACE as a risk bearing entity that exists to provide care. We have programs that are 3,000 people and others that will always have 150 people. PACE combines the intensity and personal touch of a provider with the coordination and efficiency of a health plan.
Who does PACE serve?
“PACE serves approximately 49,000 participants in 31 states—mainly individuals who are age 55 or over and certified by their state as needing a nursing home level of care. The average participant is 76 years old and has multiple, complex medical conditions, cognitive and/or functional impairments, and significant health and long-term care needs. Approximately 90% are dual eligible for Medicare and Medicaid. PACE participants must live in a PACE service area and be able to live safely in the community with PACE services at the time of enrollment.
Shawn,please tell me about the Association:
“We were incorporated in 1994 by On Lok in northern California trying to advance or transition the 13 original PACE demonstration programs to permanent provider status under Medicare. This was achieved in 1997. The Association exists to support our PACE program members through policy and advocacy, data,education, information and strategic support. We have been helping to advance the interests of PACE.
What are some of the Association’s accomplishments?
“One of the accomplishments on the Affordable Care Act was protecting PACE programs from substantial cuts imposed on Medicare Advantage plans and other capitated medical providers. We’ve been successful at helping replicate the model. We started with 15 programs and have 126 programs today.
What are some of the major initiatives this coming year and next?
“PACE 2.0 is a project intended to exponentially grow PACE to 100,000 by 2021 and 200,000 by 2028. We are doing that through helping our members to look at new operational practices that are more efficient and that achieve higher rates of enrollment. We help them create new programs to be developed and advocate for PACE pilots to service individuals not currently eligible for PACE.
Are there any federal policy initiatives we should be aware of?
“Most of what has been coming up lately has been related to Medicaid reform or payment. We’d like to see things remain stable for now. I don’t see anything substantial coming up of interest to PACE.
Does the Association provide training for physicians involved with PACE programs?
“We have a summer conference every year. The Summer Clinical Conference educates new physicians on PACE. We also have a “Medical Director Essentials” training that educates physicians who are new to PACE, but aspiring to be Medical Directors.
We are hearing more about not-for-profit PACE programs coming up. How do you seethe for-profit PACE programs? Are they starting up or are there some already?
“They are in existence—probably 10 or so (CA, MI, VA, PA, CO and NM). We don’t anticipate a substantial surge in for-profit PACE. It really takes a long view from a business standpoint to get it moving into the direction of profits that most organizations want and need. In most markets PACE programs don’t compete head to head. I don’t know of any for-profits competing with not-for-profits. I don’t see that taking place any time soon. The view on for-profits is to what degree they will initiate new programs in new markets.
Anything else you would like for healthcare executives to know about PACE?
“From a standpoint of physicians (and if you go on our website you’ll see a lot of information)—the Medical Director’s Handbook begins with a narrative about the joys of working with PACE as a clinician. You can see the difference you make.You don’t just see a person every two months. It is a model of care that allows the physicians to see a person every week. It’s very rewarding for the Clinician.”
Thank you to Shawn and the team at NPA for the work they do to support PACE programs across the country!
Rosie Saenz is a Principal &Executive Search Consultant at Morgan Consulting Resources, a healthcare executive search firm celebrating over 20 successful years in business.