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PACE 2.0 Project Overview.

Published byHector Daniel Modified over 5 years ago

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Presentation on theme: "PACE 2.0 Project Overview."— Presentation transcript:

1 PACE 2.0 Project Overview

2 Why Do We Need PACE 2.0? 2M plus Dual-eligibles need Long Term Services and Supports; PACE serves 2% of them Seniors, and potentially others, in PACE Live longer Have reduced chronic illness complications Live in the community Have fewer unmet needs Have a higher quality of life PACE has the attributes of a high performing health care delivery system Fully integrated Person centered Holistic Accountable

3 What Will PACE 2.0 Do? Chart a course for a 5X exponential growth in PACE through: Expanding current PACE organizations’ operations and service areas Initiating new PACE organizations’ to serve new areas Serving more currently eligible individuals Serving newly eligible individuals

4 PACE 2.0: Project Work Flow
Essential Elements Design Competencies Needs Addressed Target HNHC Subpopulations Health status Functional status Care gaps Growth Factors Policy Workforce Quality Spread & Scale Plan Service Areas Sponsors Prototypes August 1, – July 30, 2019

5 PACE Delivery Model Focus Groups
Essential Elements PACE Delivery Model Focus Groups PACE Innovator Site Visits PACE Literature Review October, 2017 L & M January – February, 2018 NPA Design Competencies Needs Addressed November, 2017 NPA

6 Target High Need, High Cost Populations
Define HNHC Subpopulations Develop PACE Targeting Criteria Target Subpopulation Estimates (National, State, Service Area) TBD RTI May, 2018 RTI & NPA Health Status Functional Status Care Gaps TBD RTI

7 PACE Policy Focus Groups
Growth Factors PACE Policy Focus Groups Policy Key Informant Interviews Workforce and Quality White Papers October, 2017 Truven November, 2017 Truven Policy Workforce Quality May - July, 2018 TBD

8 Prospective Sponsor Type Interviews
Spread and Scale Plan Prospective Sponsor Type Interviews Prototype Development Outreach TBD L & M Billions Institute, NPA August - December, 2018 Service Areas Sponsors Prototypes January -July, 2019 NPA

9 Project Deliverables

10 1: Report: PACE 2.0 Projected Impact Estimates
Required Steps: Related Project Team Members: Essential Elements Targeted High Need High Cost Populations L&M Policy Research RTI NPA

11 2: Chart E-Book: PACE 2.0 Projected Impact Estimates by State and Service Area
Required Steps: Related Project Team Members: Essential Elements Targeted High Need, High Cost Populations State and Federal Policy Scenarios L&M Policy Research RTI Truven NPA

12 3: Assessment: What Can We Learn from PACE Innovations
Required Steps: Related Project Team Members: L&M Focus Groups PACE Innovator Site Visits Literature Review L&M Policy Research NPA

13 4: Growth Plan: Scale and Spread Strategies for PACE 2.0
Required Steps: Related Project Team Members: Essential Elements Targeted HNHC Populations Policy Scenarios Workforce Quality L&M Policy Research RTI Truven NPA Billions Institute TBD White Paper Authors

14 5: Provider Action Guide: Prioritizing and Planning for PACE Growth Opportunities
Required Steps: Related Project Team Members: Growth Plan (and its preceding deliverables) Prospective Sponsor Key Informant Interviews Prototype Development NPA Billions Institute L&M Policy Research

15 6: Outreach Required Steps: Related Project Team Members:
Provider Action Guide Outreach Plan NPA All – opportunities to present/disseminate project findings

16 Project Questions and Concepts

17 Underserved and Unserved: HNHC populations
Underserved – currently eligible Duals Medicare-only Veterans Unserved – pilot populations Age Level of Care

18 Underserved and Unserved: Service Areas
Rural Current Programs, limited growth Current States, limited access Unserved – States without PACE Potential for Medicare Only

19 Policy Scenarios Federal State Pilots Medicare-only changes
Part D Plan Choice Health Status Adjusted Rates 2-way (Medicare-only) Program Agreements State Enrollment Caps Program Caps New States

20 Sponsors Current PACE Organizations New Sponsors Sponsor Partnerships
Health Systems Health Plans ACOs FQHCs LTSS Providers Sponsor Partnerships Acute care and LTSS Current PACE and new PACE Delivery and Risk Management

21 Prototypes Payers MCOs ACOs Providers Participant Pathways
FFS entry points Care management

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