Program of All-Inclusive Care for

the Elderly

PACE

Dr. Adam Vossen, Medical Director, Immanuel Pathways

Randy Ehlers, MSW, Executive Director, Siouxland PACE

What is PACE?

Comprehensive Care

Community Based

Coordinated

Capitated

Who Does PACE Serve?

55 and older

Meet Nursing Facility Level of Care

Able to live safely in the Community with PACE services

How Does PACE Operate?

PACE Center

• Primary Care

• Rehabilitative Care

• Activities

• Meals

In-Home Services

Transportation

Contracted Network

• Specialists

• Hospitals

• Assisted Living

• Other

Integrated Service Delivery and Team

Managed Care

Outcomes

Comprehensive Care

• Coordination of all care

• Reduce unmet needs

• Improve chronic care management

• Functional support

Delay or prevent long term placement

Higher quality of life

PACE Costs

Reduce high cost of uncoordinated care

• Fewer hospitalizations

• Reduction of emergency room use

Capitation = Predictable

PACE rate less than current Medicaid costs

No copays

Who Pays for PACE Care

PACE is a financially at-risk capitated program, serving as a medical

provider and health plan for enrolled members

PACE provides services above and beyond those covered by Medicare

and Medicaid

Organizations receive a per member, per month payment to deliver all

necessary care

Breakdown of participant eligibility (percentages are approximates)

• 90% dually eligible for Medicaid and Medicare

• 9% Medicaid only

• 1% private pay, Medicare only, other

PACE in Iowa

Total Number of Individuals served in Iowa: 558

Siouxland PACE

Immanuel Pathways -

Southwest Iowa

Immanuel Pathways –

Central Iowa

11

Immanuel Pathways - Southwest Iowa

Location: Council Bluffs, IA

Opening Date: January 2012

Service Area: Mills, Pottawattamie, and Harrison Counties

Enrollment: 177 participants (~23% penetration of eligibles)

55-64: 24%

65+: 76%

Center Capacity: 230-240 participants

12

Immanuel Pathways - Central Iowa

Location: Windsor Heights, IA

Opening Date: October 2015

Service Area: Boone, Dallas, Jasper, Madison, Marion, Marshall, Polk,

Story and Warren counties

Enrollment: 164 participants (~4% penetration of eligibles)

55-64: 30%

65+: 70%

Center Capacity: 250 participants

Siouxland PACE

Location: Sioux City, IA

Opening Date: September 2008

Service Area: Woodbury, Plymouth, Cherokee, and Monona counties

Enrollment: 197 participants (~20% penetration of eligibles)

55-64: 28.4%

65+: 71.6%

Center Capacity: 270 participants

What the PACE Population Looks Like

Immanuel

Pathways –

Central Iowa

Immanuel

Pathways –

Southwest Iowa Siouxland PACE

Average Age 72 72 70

Minimum Age 56 56 56

Maximum Age 98 100 94

Female

Percentage 65% 62% 58%

Independent

Living 94% 89% 86%

What the PACE Population Eligibility

Looks Like.

Immanuel Pathways

– Central Iowa

Immanuel Pathways

– Southwest Iowa Siouxland PACE

Dual 157 95.7% 166 93.8% 173 88%

Medicare Only 1 .6% 0 0% 7 3%

Medicaid Only 6 3.7% 11 6.2% 17 9%

Barriers for PACE

Strict cut-off dates for enrollment

Awareness in the State of Iowa

Lack of referrals from the Enrollment Brokers to PACE

Substantial start up capital

Methodology used to calculate PACE payments

Questions?