Setting the PACE for Senior Health & Wellness

Franciscan St. Francis Health Launches Indiana’s First PACE Program

Linda and her 89-year-old mother, Margaret, had been shopping together for years. But their shopping trips were becoming increasingly difficult, as Margaret was experiencing frequent falls.

Determined to find the care her mother needed, Linda started searching for skilled nursing facilities when she heard about Franciscan Senior Health & Wellness. In January she began taking her mother to physical therapy twice a week at Franciscan Senior Health & Wellness PACE program, located at Southport and Franklin Road in Indianapolis.

Programs of All-inclusive Care for the Elderly (PACE) is a Medicare initiative that serves frail, elderly Medicare and Medicaid beneficiaries with chronic care needs by providing access to the full continuum of preventative, primary, acute and long-term care services. While 116 PACE programs exist in 32 states across the country, Franciscan Senior Health & Wellness is the first in Indiana.

Within months of visiting the Franciscan Senior Health & Wellness Day Center, the frequency of Margaret’s falls had decreased, and she was able to continue shopping and living at home with Linda. In addition, Margaret was telling her daughter to wait until after BINGO to pick her up from the Center. She’d met some new friends.

“PACE is a fantastic option for a health care system to provide the entire continuum of care,” says Susan Waschevski, director of PACE at Franciscan Alliance. “While fee-for-service programs available to the elderly work well for many people, the population we serve has a huge need for the increased care coordination that PACE is designed to provide.”

Launched in January 2015, the Franciscan Senior Health & Wellness PACE program serves participants living in southeastern Marion and Johnson counties. In order to be eligible for PACE, patients must be 55 or older, certified by the state of Indiana to meet nursing-home-level of care, able to live safely in the community at the time of enrollment and reside in a PACE service area.

“Franciscan launched the PACE program because we understood that the health care delivery system needed to do a better job of assisting Medicare beneficiaries with multiple chronic diseases,” says Jay Brehm, senior vice president of strategic planning and business development for Franciscan Alliance. “The PACE program fits with this service orientation.”

The goal of PACE is simple: to keep participants living in the community rather than in long-term care institutions. A year into this bold initiative, PACE is working—not only for Linda and her mother, but also for 35 other participants, in large part due to the program’s Day Center.

THE DAY CENTER: THE HEART AND SOUL OF PACE

The Franciscan Senior Health & Wellness PACE Center includes three physician exam rooms, a space for outpatient therapy, a 1,000-square-foot dining and recreational room, a walk-in shower facility and a quiet room. Participants receive therapy and medical services from an 11-member interdisciplinary team of professionals, ranging from physicians and physical therapists to recreational therapists and dietitians.

The team utilizes attendance at the Day Center to monitor the health status of participants and manage their clinical care and supportive service needs. Most teams meet weekly to discuss the needs of their participants; family members are often a part of those conversations.

In addition to the care participants receive from their team, PACE also provides home health and personal care; all necessary prescription drugs; social services; medical specialties, such as audiology, dentistry, optometry, podiatry and speech therapy; respite care; and hospital and nursing home care when necessary.

A HIGHLY INDIVIDUALIZED ONE-STOP SHOP

“One of the biggest benefits to our participants is that they can go to one place to meet all of their health care needs,” Waschevski says. “Participants eligible for Medicare and Medicaid pay nothing out of pocket. Participants eligible for Medicare only make one payment a month, and it covers all their needs—whether they go daily, five times a month, once a month or they end up in the hospital, their payment doesn’t change. For families struggling to budget for health care, it’s very predictable.”

Participants also benefit from increased care coordination and highly individualized services from a group of caregivers who have come to understand the holistic needs of their patients.

Thus far, patient response has been overwhelmingly positive. “To date, we have not had anyone drop out of the system from dissatisfaction,” Waschevski says. “We’re also getting a high number of patient referrals. Word of mouth has been fantastic.”

“It’s a wonderful program,” adds Brehm. “Once people get into PACE, they tend to stay with the program for a long time.”

Beyond the Center’s amenities, services and the expertise of the interdisciplinary teams, many PACE participants benefit from the sense of community PACE fosters. “The social aspect is far more important than you can ever quantify with data,” Waschevski notes. “Participants forge friendships and experience increased accountability and support from one another. A lot of our folks don’t have as much family as they used to, so the social piece of PACE is particularly beneficial.”

THE FUTURE OF PACE IN INDIANA

Franciscan Senior Health & Wellness PACE participants aren’t the only ones benefitting from this unique model. PACE programs offer health care providers the ability to meet increasing consumer demands for individualized care and supportive service arrangements, as well as coordinate care for individuals across settings and medical disciplines.

In addition, PACE’s capitated funding arrangement rewards providers that are flexible and creative in offering the best care possible—providers like Franciscan Senior Health & Wellness. “The Sisters strongly support the PACE model,” Waschevski says. “We hope to add five new enrollees each month at our current Center and expand the PACE program into northern Indiana in 2016 and beyond.”

The expansion of PACE in Indiana could mean increased quality of life for hundreds of Hoosiers like Linda’s mother: fewer falls, more mother/daughter shopping trips and a new set of friends.