Access PACE 2.0 Resources and Tools

Interactive Map of Potentially PACE-Eligible Populations

With the support of The John A. Hartford Foundation, West Health, and The Commonwealth Fund, NPA conducted an analysis to identify unserved, potentially PACE-eligible populations. The estimates identify the older adult population that would qualify clinically for PACE and, based on financial data, also qualify for Medicaid.

More than two-thirds (67 percent) of Medicaid-eligible older adults with complex care needs do not have access to PACE. In the 31 states where PACE operates, more than 885,000 potentially PACE-eligible older adults, who would be eligible for Medicaid, do not have access to a PACE program. In the District of Columbia and the 19 states that do not currently have PACE, more than 377,000 potentially PACE-eligible older adults, who would be eligible for Medicaid, do not have access to PACE.

NPA developed an interactive map to allow those interested in health care for older adults to identify the potential PACE-eligible population that currently does not have access to PACE. The map provides a heat map at the state and health service area (HSA) level for communities without access to PACE.

The map can be used to help those interested in establishing or growing a PACE program to identify areas with an unmet need. States can use the map for information on the percentage of potentially PACE-eligible individuals who have access to a PACE program, as well as the estimated percentage of the population PACE is currently serving.

As part of the analysis, NPA also developed estimates of the potentially eligible population in current PACE service areas at the ZIP code level. If your organization would like additional information on estimates of the eligible population at the ZIP code level in your PACE service area or unserved areas you are exploring, please contact Anita Gibson, senior director of Project Management and Policy Communications at NPA.

Estimates are based on U.S. census data for those age 65 and over related to civilian non-institutionalized status, self-care disability, independent living disability and household income. Based on past data reported by PACE organizations on the percentage of PACE enrollees ages 55-64, the estimate of the potentially PACE-eligible population was adjusted to estimate the total potentially PACE-eligible population of adults age 55 and over.

PACE Net Enrollment Increases 55 Percent in 2019

For the last nine months net enrollment in PACE has been trending upwards. From April through December 2019, monthly net new enrollments remained above historical baseline levels. In 2019 enrollment substantially increased in November and December, despite historically near or below baseline enrollment during these months in previous years.

December 2019 net new enrollment represents a 55 percent increase from net new enrollment in December 2018. While new PACE organizations significantly contributed to this growth, approximately 89 percent of the December net new enrollments were at PACE organizations operating during the previous year.

We are excited about the continued work with our members and partners through initiatives such as PACE 2.0 to help PACE grow to serve more older adults.


‘PACE Setters’ for the Fourth Quarter of 2019

PACE programs served an additional 1,644 participants in the fourth quarter of 2019, bringing the total estimated number of participants to 53,899 at the end of December (including Medicaid-only participants). For new participants PACE growth means a higher quality of life and care, with fewer hospitalizations, emergency room visits and nursing home stays.

The PACE 2.0 project of the National PACE Association (NPA) is working with PACE organizations that are setting the pace for growth to learn how they are achieving faster growth and broader reach in their communities. These “PACE Setters” are setting new standards for monthly net enrollments, growth rates and market penetration in the communities they serve.

NPA recognizes PACE Setters for leading the way in PACE growth and access in the following categories:

  • “Supernovas” achieved an estimated average net enrollment of 10 or more.
  • “Shooting Stars” had an estimated growth rate of 9 percent or more.
  • “North Stars” served an estimated 20 percent or more of people age 55 or over in their community who need LTSS and are dually eligible or eligible for Medicaid.
  • “Emerging Lights” achieved an estimated net enrollment of 10 or more in at least one month of the quarter.

NPA is proud to recognize the following PACE organizations for their growth during the fourth quarter of 2019. These lists will be updated each quarter to recognize high achievers in the areas of growth and community service. By working to ensure that people needing long-term services and supports (LTSS) in their communities are aware of PACE and have the opportunity to receive the comprehensive, coordinated care provided, these programs are reaching new levels of impact on the lives of the participants and communities they serve.

Achieving the distinction of Supernovas for the fourth quarter were AltaMed, CalOptima PACE, Fresno PACE, San Diego PACE, St. Paul's PACE and Sutter SeniorCare PACE in California; Florida PACE Centers, Inc., and Palm Beach PACE in Florida; Midland Care PACE in Kansas; PACE Southeast Michigan; Providence ElderPlace Portland in Oregon; Community LIFE and LIFE Geisinger in Pennsylvania; and Providence Health System in Washington.

Emerging Lights were Center for Elders' Independence, Family Health-Center for Older Adults, Gary and Mary West PACE, On Lok Lifeways, Pacific PACE and Stockton PACE in California; Rocky Mountain PACE, Senior CommUnity Care of Colorado, and TRU PACE in Colorado; Franciscan Senior Health & Wellness in Indiana; Neighborhood PACE and Summit ElderCare in Massachusetts; Senior Care Partners PACE in Michigan; Independent Living Services of Central New York; LIFE St. Joseph of the Pines in North Carolina; McGregor PACE in Ohio; Valir PACE Foundation in Oklahoma; LIFE Beaver and Lawrence Counties, LIFE Northwestern Pennsylvania and Senior LIFE Altoona, Inc., in Pennsylvania; PACE Organization of Rhode Island; and International Community Health Services in Washington.

Shooting Stars were PACE of the Ozarks in Arkansas; CalOptima PACE, Redwood Coast PACE, San Diego PACE, Stockton PACE and Sutter SeniorCare PACE in California; TRU PACE in Colorado; Midland Care PACE in Kansas; Community PACE at Home, Inc., Genesys PACE of Genesee County, Great Lakes PACE, PACE Central Michigan and Thome PACE in Michigan; Fallon Health Weinberg-PACE in New York; Elderhaus PACE in North Carolina; LIFE Geisinger in Pennsylvania; and Prisma Health SeniorCare PACE-Upstate in South Carolina.

North Stars were Fresno PACE and Redwood Coast PACE in California; Rocky Mountain PACE and Senior CommUnity Care of Colorado in Colorado ; Siouxland PACE in Iowa; Neighborhood PACE in Massachusetts; Complete Senior Care, Eddy SeniorCare, ElderONE and Independent Living Services of Central New York in New York; Northland PACE Senior Care Services in North Dakota; LIFE Beaver and Lawrence Counties in Pennsylvania; and Wyoming PACE.

(Note: Census and net enrollment numbers were estimated based on CMS monthly Medicare enrollment data adjusted to include Medicaid-only enrollment, which is estimated based on Medicaid-only census ratios reported annually to NPA by PACE organizations. Market penetration rates are based on estimated enrollment, divided by the estimated number of people who are clinically eligible for PACE with Medicare and Medicaid coverage in the service area of the PACE organization using Census data. Service areas are defined based on ZIP codes provided to NPA by PACE organizations.)

PACE 2.0 Learning Collaborative Doubles Net Monthly Enrollment

Under the PACE 2.0 initiative, with the support of The John A. Hartford Foundation, West Health, and the Gordon and Betty Moore Foundation, the National PACE Association (NPA) launched the West Coast Learning Collaborative in October 2018 as a 12-month collaborative to pilot and refine the PACE 2.0 Growth Model. The growth model outlines a collection of strategies and tactics to help PACE organizations grow exponentially and increase the number of elderly people with complex care needs that PACE serves.

The West Coast Learning Collaborative includes 10 PACE organizations, which set the group aim of reaching an average net monthly enrollment (gross enrollments less all disenrollments) of 15 and growing to serve an additional 1,867 participants over the course of a year.

Leveraging the IHI Breakthrough Series methodology, which includes each organization conducting rapid-cycle, small-scale tactic tests called PDSAs, and the PACE 2.0 Growth Model, the collaborative was able to more than double their average net enrollment from a baseline of eight per month to 17. Based on the continued work and strides of its members in increasing enrollment, the group is poised to achieve its census aim by early 2020.

With the assistance of the West Coast Learning Collaborative members, NPA is finalizing a PACE 2.0 Exponential Growth Implementation Guide that will include an updated and more detailed PACE 2.0 Growth Model and additional guidance on utilizing the model. In January the guide will be shared through the PACE 2.0 Growth and Learning e-Community. PACE organizations can join the e-community by completing this brief form, which asks you to provide your contact information and share the 2021 growth aim for your organization. To see if your organization already is a member of the e-community and has shared its growth aim, view the member list.

NPA thanks the PACE organizations that have shared their PACE 2.0 2021 growth aims. We look forward to working with you to help implement strategies that will support you in growing to serve more of the frail elderly residents in your communities.

For more information, contact Anita Gibson.


Members of the West Coast Learning Collaborative celebrate doubling their average net monthly enrollment.

‘PACE Setters’ for the Third Quarter of 2019

The third quarter of 2019 saw Programs of All-Inclusive Care for the Elderly (PACE®) serve an additional 1,297 participants nationally, bringing the total estimated number of participants to 52,255 in September. For these new participants, PACE growth means a higher quality of life and care, with fewer hospitalizations, emergency room visits and nursing home stays.

The PACE 2.0 project of the National PACE Association (NPA) is working with PACE organizations that are setting the pace for growth to learn how they are achieving faster growth and broader reach in their communities. These “PACE Setters” are setting new standards for monthly net enrollments, growth rates and market penetration in the communities they serve.

Nationally, an average PACE organization grows at the rate of three participants a month. However, in the third quarter of this year, 30 NPA member PACE organizations added a net enrollment of 10 or more in at least one month. Of these, 10 averaged this level of enrollment over an entire quarter.

Another way of measuring growth is the percentage increase in enrollment over a period of time. Though the national average quarterly growth rate is 2.1 percent, 11 PACE programs achieved 9 percent or better in the third quarter.

In addition to growth, PACE organizations are seeing new levels of service to their communities as measured by market penetration. Market penetration is the percentage of dual Medicare and Medicaid and Medicaid-only eligible people needing long-term services and supports (LTSS) in the service area of a PACE organization who are enrolled in PACE. While market penetration averages 9 percent nationally, 14 NPA member PACE organizations are serving 20 percent or more of estimated eligible people in their communities who need LTSS.

Leading the Way in PACE Growth and Access

NPA recognizes PACE Setters for leading the way in PACE growth and access in the following categories:

  • “Supernovas” achieved an estimated average net enrollment of 10 or more.
  • “Shooting Stars” had an estimated growth rate of 9 percent or more.
  • “North Stars” served an estimated 20 percent or more of people age 55 or over in their community who need LTSS and are dually eligible or eligible for Medicaid.
  • “Emerging Lights” achieved an estimated net enrollment of 10 or more in at least one month of the quarter.

NPA is proud to recognize the following PACE organizations for their growth during the third quarter of 2019. These lists will be updated each quarter to recognize high achievers in the areas of growth and community service. By working to ensure that people needing LTSS in their communities are aware of PACE and have the opportunity to receive the comprehensive, coordinated care provided, these programs are reaching new levels of impact on the lives of the participants and communities they serve.

Achieving the distinction of Supernovas for the third quarter were AltaMed Health Services Corporation, Fresno PACE, On Lok Lifeways, San Diego PACE and St. Paul's PACE in California; Florida Pace Centers, Inc.; Element Care, Inc., and Neighborhood PACE in Massachusetts; PACE Southeast Michigan; and Providence Health System in Washington.

Emerging Lights were PACE of the Ozarks in Arkansas; CalOptima PACE and Sutter SeniorCare PACE in California; Rocky Mountain PACE in Colorado; Palm Beach PACE in Florida; Siouxland PACE, Inc. in Iowa; Midland Care PACE in Kansas; LIFE Circles and Thome PACE in Michigan; Independent Living Services of Central New York; Cherokee Elder Care and LIFE PACE, Inc., in Oklahoma; Providence ElderPlace Portland in Oregon; Community LIFE, LIFE Geisinger, LIFE Northwestern Pennsylvania, Senior LIFE Lehigh Valley, Inc., and Senior LIFE York, Inc., in Pennsylvania; and Centra PACE in Virginia.

Shooting Stars were San Diego PACE and Stockton PACE in California; TRU PACE in Colorado; Genesys PACE of Genesee County, PACE Central Michigan, PACE Southeast Michigan and Thome PACE in Michigan; LIFE PACE, Inc. in Oklahoma; LIFE Geisinger in Pennsylvania; Centra PACE in Virginia; and Providence Health System in Washington.

North Stars were Fresno PACE and Redwood Coast PACE in California; Rocky Mountain PACE and Senior CommUnity Care of Colorado; Siouxland PACE, Inc., in Iowa; Neighborhood PACE in Massachusetts; Complete Senior Care, Eddy SeniorCare, ElderONE, an Affiliate of Rochester Regional Health, and Independent Living Services of Central New York; Northland PACE Senior Care Services in North Dakota; LIFE Beaver and Lawrence Counties and LIFE Northwestern Pennsylvania; and Wyoming PACE.

(Note: Census and net enrollment numbers were estimated based on CMS monthly Medicare enrollment data adjusted to include Medicaid-only enrollment, which is estimated based on Medicaid-only census ratios reported annually to NPA by PACE organizations. Market penetration rates are based on estimated enrollment, divided by the estimated number of people who are clinically eligible for PACE with Medicare and Medicaid coverage in the service area of the PACE organization using Census data. Service areas are defined based on ZIP codes provided to NPA by PACE organizations.)

PACE Setters for the First Two Quarters of 2019

Webinar on Driving Growth

What are the first steps for setting your PACE organization on the pathway for exponential growth? Mary Naber, president and CEO of PACE Southeast Michigan, discussed key strategies and tactics for creating a culture of growth in a webinar titled "PACE 2.0: Driving Growth by Setting Clear Aims and Creating a Context for Change" on Sept. 24.

The recorded webinar is now available for viewing.

Help Keep the Momentum Going

PACE growth continues to be strong. The net enrollment for April exceeded the enrollment growth for the same month of each of the past three years to help the program grow to serve more than 50,000 participants.

Estimated net enrollment growth in April was 362, compared to growths of 336, 189 and 272 during the same month in the past three years.


Share Your Growth Aim

To date, 20 PACE organizations have shared their PACE 2.0 growth aims, with a collective aim of serving 10,542 participants by the end of 2021.

If you haven’t already shared your December 2021 growth aim with NPA, please email Anita Gibson with your targeted December 2021 census and the average net monthly enrollment that would be needed to achieve your aim.

Why set a growth aim? To guide your work, to plan ahead, and to motivate and engage. Setting an aim has been shown to increase the likelihood of achieving that goal by 65% or more. To learn more about setting a growth aim, you can view the recording of the webinar on Using Your PACE 2.0 Growth Aim Toolkit to Accelerate Growth: What’s in an Aim? You also can view the PowerPoint presentation. The webinar reviewed the market-specific demographics, growth benchmarks, and tools for growth provided to PACE organizations in the Growth Aim Toolkit. The presenters discussed how to use this information to set an ambitious and achievable goal for accelerating the growth of PACE organizations.

NPA is grateful to the following organizations that have shared their December 2021 PACE 2.0 Growth Aims as of May 1:

  • AllCARE for Seniors (VA)
  • AtlantiCare LIFE Connection (NJ)
  • CalOptima (CA)
  • CarePartners PACE (NC)
  • Centra PACE (VA)
  • Florida PACE Centers, Inc. (FL)
  • Franciscan Senior Health & Wellness (IN)
  • Midland Care PACE (KS)
  • PACE of Southwest Michigan (MI)
  • PACE Organization of Rhode Island (RI)
  • Palm Beach PACE (FL)
  • Providence ElderPlace (WA)
  • Rocky Mountain PACE (CO)
  • Senior Care Partners (MI)
  • Sentara PACE (VA)
  • Siouxland PACE (IA)
  • SpiriTrust Lutheran LIFE (PA)
  • Sutter SeniorCare (CA)
  • Total Life Healthcare (AR)
  • Wyoming PACE (WY)

Video Series: Before I Found PACE

"Before I Found PACE" is a video series that illustrates the need for expanding Programs of All-Inclusive Care for the Elderly (PACE®) through the stories and words of PACE participants and caregivers. The video series is part of the PACE 2.0 initiative, which is supported by The John A. Hartford Foundation and West Health.

The ninth video in the series features Alfonzer Brooks, a veteran from Detroit whose health issues threatened his independence. He enrolled in PACE Southeast Michigan, which provides the care and assistance he needs to be more independent.

View other videos in the series.

PACE 2.0: NPA Update

PACE 2.0 is looking at ways to exponentially increase the number of people served by PACE organizations across the country. In this April 20, 2018, NPA Update, Peter Fitzgerald, executive vice president of Policy and Strategy at NPA, describes the approach of the project and its early results.

Webinar to Review Initiative Approach and Progress

A webinar was held on April 20 regarding the PACE 2.0 initiative, which is identifying strategies for achieving exponential PACE growth, with the goal of 200,000 PACE participants by 2028. The webinar reviewed the approach of the initiative and the progress to date in identifying the essential elements of the PACE model, evidence-based growth strategies and state policy factors. The webinar also presented opportunities for PACE organizations to get involved in upcoming activities.

For more information, contact Peter Fitzgerald.

PACE 2.0: Charting a Course for Exponential PACE Growth

NPA has launched the PACE 2.0 project with support from The John A. Hartford Foundation and the West Health Policy Center. The initiative will expand access to PACE for many complex high-need, high-cost populations across the country. The organizations recently approved $795,585 in funding over two years, with the goal of innovating the PACE model to serve more seniors and other individuals with high-care needs.

“NPA is deeply grateful to The John A. Hartford Foundation for its longstanding support of PACE and is thrilled to be working with West Health as a new partner in our ongoing efforts to expand access to the provider-based, fully integrated health care delivery model of PACE,” said Shawn Bloom, president and CEO of NPA.

The PACE 2.0 initiative will build upon the PACE Innovation Act, legislation passed by Congress that allows for PACE pilots to develop innovations supporting the ability of PACE to serve a larger number and wider range of adults with high health care needs. The project will identify underserved subpopulations currently eligible to enroll in PACE, as well as new unserved populations, such as younger adults with physical or mental challenges, that could benefit from the PACE model. To meet the needs of these individuals, the project will support the development of strategies to scale PACE operations and spread the model to more communities. The goal is to achieve a five-fold increase in those served by PACE and promote implementation of the strategies developed.

“This project charts a course for bringing the transformative care model of PACE to many more communities and people who will benefit from its integrated, person-centered approach,” said Peter Fitzgerald, executive vice president for Policy and Strategy at NPA and the principal investigator for the project. “Through scale and spread strategies developed by the project, we look forward to achieving exponential growth in access to PACE for older Americans and those with complex health care needs.”

PACE uses an interdisciplinary team approach to provide care to older individuals who qualify for nursing home care. PACE is a Medicare benefit nationally and a Medicaid benefit in 31 states. PACE is the most successful model for keeping individuals out of nursing homes and in the community, where they enjoy a higher quality of life, remain connected to the community, and receive care in the most cost-effective way. PACE has proven its ability to reduce costs associated with emergency room visits, unnecessary hospital admissions and long-term nursing home placements. PACE data show that more than 95 percent of PACE enrollees live in the community.

The John A. Hartford Foundation, based in New York City, is a private, nonpartisan philanthropy dedicated to improving the care of older adults. Established in 1929, the foundation has three priority areas: creating age-friendly health systems, supporting family caregiving, and improving serious illness and end-of-life care.

Solely funded by philanthropists Gary and Mary West, West Health includes the nonprofit and nonpartisan Gary and Mary West Health Institute and Gary and Mary West Foundation in San Diego and the Gary and Mary West Health Policy Center in Washington, DC. These organizations are working together toward a shared mission dedicated to enabling seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life, and independence.

For more information, contact Peter Fitzgerald.

Resource Library

Updates

Kick-Off Meeting Presentations

Essential Elements

Targeting High-Need, High-Cost Subpopulations

Growth Factors

Spread and Scale Plan

There are more than 260 PACE centers in 31 states. Find your local PACE program.

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