WelbeHealth Issues Statement on Passage of 2023-2024 Budget

Menlo Park, CA – Amy Shin, Chief Mission Officer, WelbeHealth issued the following statement in response to the California Legislature passing a 2023-2024 state budget:

“WelbeHealth appreciates the commitment the California Legislature made to support vulnerable seniors by passing a budget that includes additional resources for Programs of All-Inclusive Care for the Elderly (PACE). Increasing the capacity of the Department of Health Care Services to administer PACE will help ensure that more eligible frail seniors have access to PACE and can more quickly benefit from comprehensive care.

“Securing additional resources for DHCS was a priority for WelbeHealth and CalPACE, and WelbeHealth worked in close collaboration with a coalition that included Leading Age California, California League of United Latin American Citizens, and American Nurses Association\California to ensure this important budget item passed.

“WelbeHealth is grateful to the Governor and the California Legislature for their support of PACE, and we look forward to further collaboration so we can continue to grow this critical program and improve the quality of life for aging seniors.”

ABOUT PACE

Program of All-Inclusive Care for the Elderly (PACE) is a comprehensive, whole-person health care program for frail seniors living with chronic health conditions and other complex needs that enables them to continue to live in the communities they know and love. PACE is a high-quality cost-effective alternative to nursing home care, costing on average 15% less than the cost of caring for a comparable population through other Medi-Cal services.

PACE organizations have a proven track record of seamlessly planning and managing all aspects of care for seniors – medical, social, and supportive services. PACE participants are over the age of 55, live in a PACE service area, and have been deemed eligible by the state for a nursing home level of care. More than 70% of PACE participants are dually eligible for Medicare and Medi-Cal.

ABOUT WELBEHEALTH

WelbeHealth is a physician-led, mission-driven organization founded to serve the most vulnerable seniors with compassionate and quality care, in a pure value-based model. WelbeHealth manages the entire care portfolio for participants including their primary, specialty, and behavioral health care, ensuring they get to and from appointments, helping them navigate any necessary paperwork, providing assistance with activities of daily living, and ensuring they have enriched lives through social and emotional care.

WelbeHealth Continues Los Angeles Expansion With Opening of New PACE Centers in Rosemead and North Hollywood


Through the Medicare and Medi-Cal funded Program of All-Inclusive Care for the Elderly (PACE), WelbeHealth delivers fully integrated care that allows seniors to age in place

Both new locations are poised to meet the needs of an aging population across greater metro LA; thousands of residents local to the new centers are over 55 and eligible for PACE

See photos of the new spaces here

Today the physician-led senior health services provider WelbeHealth announced the opening of its Rosemead and North Hollywood locations. The new locations will increase access to care in underserved communities where thousands of lower-income older adults qualify for health care through the Program of All-Inclusive Care for the Elderly (PACE), a national Medicare and Medicaid program that offers seniors access to comprehensive at-home and community-based services.

The expansion marks a greater Los Angeles metro area presence for WelbeHealth, which also operates centers in Long Beach and Pasadena. Both WelbeHealth Rosemead and WelbeHealth North Hollywood will offer spaces for medical and dental care, social recreation, physical and occupational therapy, personal care, meals and nutritional counseling. Transportation and in-home care are also delivered as part of WelbeHealth’s integrated services. 

Aligned with WelbeHealth’s commitment to holistic health, the new locations are thoughtfully designed contemporary spaces, inspiring an environment where participants can feel mentally rejuvenated while receiving high-quality medical care. Features like outdoor social spaces, hair salons and laundry rooms offer a respite from loneliness and limited access to personal care that many lower-income older adults experience. 

“Welbe’s purpose is to unlock the full potential of the most frail and vulnerable seniors through a model of clinical excellence, comprehensive social services and our courage to love culture, that values every one of our team members, our participants and their families. We see a huge need for services like this in the Rosemead and North Hollywood communities,” said Si France, MD, Founder and CEO at WelbeHealth. “We know that caring for this population has ripple effects throughout their families and their communities, and we’re honored to serve them.”

Both centers are currently enrolling new participants, with services set to begin on July 1.

Over 9,000 seniors are eligible for PACE within a 20-minute drive of the two centers. The surrounding populations are highly diverse, with over half of local seniors primarily speaking a non-English language including Spanish and Chinese. To meet the needs of its participants, WelbeHealth has employed multilingual staff members across many positions. Culturally appropriate meal menus, activities, and other services have been made available to best serve the needs of the local communities.

“California’s population is aging rapidly. We are expanding our presence in Southern California to meet the growing need for specially designed services that allow seniors to thrive in their communities while lowering costs compared to institutional care. Our mission to serve the most vulnerable seniors with better quality and compassion will lift the burden off family members and improve the lives of older adults,” said Vaneesh Soni, MD, Chief Growth Officer at WelbeHealth

In addition to the new North Hollywood and Rosemead centers, WelbeHealth operates programs across California, including in the cities of Modesto, Stockton, Pasadena, Long Beach and Fresno. 

About WelbeHealth

WelbeHealth is a physician-led public benefit company founded in 2015 that provides comprehensive healthcare services for seniors through a fully integrated program that includes all medical and dental care, physical and occupational therapy, transportation to medical appointments, meals and personal care services. WelbeHealth addresses social determinants of health to keep the most vulnerable seniors living safely in their own homes. Services are delivered through the Program of All-Inclusive Care for the Elderly (PACE), a national Medicare and Medicaid program. 

For more information, please visit welbehealth.com.

Contact: Ryan Jackson, welbehealth@berlinrosen.com

WelbeHealth responds to Governor’s budget proposal

MENLO PARK, CALIF. – Today, Governor Gavin Newsom released his state budget proposal for fiscal year 2023-2024. The budget included several proposals in line with WelbeHealth’s policy priorities, including an increase in resources for Program for All-Inclusive Care of the Elderly (PACE) administration within the Department of Health Care Services and the maintenance of funding for key health and human services programs including CalAIM, behavioral health and housing programs, and ensuring access to health care for all Californians regardless of documentation or ability to pay. 

PACE enables frail seniors to remain in their homes while receiving coordinated, whole-person care and is a high-quality cost-effective alternative to nursing home care. In recent years, the number of PACE participants has increased significantly. 

“WelbeHealth applauds the governor’s support of Programs of All-Inclusive Care for the Elderly (PACE) and other proven care models for frail and vulnerable seniors.  For every participant that enrolls in PACE, it saves taxpayers tens of thousands of dollars while increasing their length and quality of life, allowing them to live at home.  Whether from an economic, health care or social standpoint, this may be one of the best investments the administration could make,” said Si France, M.D., chief executive officer of WelbeHealth, in response to the proposed budget.

To learn more about Governor Newsom’s full budget proposal, you can click here: 2023-24 State Budget Invests in Californians while Safeguarding State’s Future

About Program for All-Inclusive Care of the Elderly (PACE)

Program for All-Inclusive Care of the Elderly (PACE) is a comprehensive whole-person health care program for frail seniors living with chronic health conditions and other complex needs. As both insurers and providers, PACE organizations are able to seamlessly plan and manage all aspects of care for seniors – medical, social and supportive services. PACE participants are over the age of 55, live in a PACE service area and have been deemed eligible by the state for a nursing home level of care. 90% of PACE participants are dual eligible for Medicare and Medicaid.

About WelbeHeatlh

WelbeHealth is a physician led, mission-driven organization founded to serve the most vulnerable seniors with compassionate and quality care, in a pure value-based model. WelbeHealth manages the entire care portfolio for participants including their primary and specialty care, ensuring they get to and from appointments, helping them navigate any necessary paperwork, providing assistance with activities of daily living, and ensuring they have enriched lives through social and emotional care. 

Contact: Cyndi Hillery, cyndi.hillery@welbehealth.com

WelbeHealth Deepens Commitment to Serving Seniors with Executive Hires

MENLO PARK, CALIF. – Physician-led healthcare organization WelbeHealth has added two seasoned executives to its leadership team: Chief Mission Officer Amy Shin and Chief People Officer Cathy Fraser. The leaders will play a pivotal role as WelbeHealth continues to deliver on its mission to serve the most vulnerable seniors in its communities.

As chief mission officer, Shin ensures that WelbeHealth’s mission is front and center in the community and among policy makers and our regulatory partners. She works closely with the operations teams to ensure that WelbeHealth is continually delivering on the highest standards of clinical quality and compliance. Shin has more than 25 years of healthcare leadership experience, most recently as chief executive officer of the Health Plan of San Joaquin, where she oversaw health care delivery for 350,000 MediCal lives in underserved areas of California.  Shin was the chief administrative officer at On Lok, the first PACE organization, and the Alameda Alliance for Health. She holds a bachelor’s degree from the University of California, Berkeley and a Doctor of Pharmacy from the University of Southern California.

“Amy is a tremendously well respected and connected leader in California’s healthcare landscape, and she’s spent her career doing mission-driven work for vulnerable populations,” said Si France, MD, chief executive officer of WelbeHealth. “It is an honor that she would choose to support and advance WelbeHealth’s mission.”

As chief people officer, Fraser is responsible for the people strategies and services that enable team members to effectively fulfill and expand the WelbeHealth mission. Her focus is on maintaining WelbeHealth’s commitment to values and culture, developing career pathways, elevating team member experience, and investing in diversity, equity and inclusion. She most recently led human resources at Mayo Clinic, US News and World Report’s #1 Hospital, and Tenet Healthcare Corporation (NYSE: THC), a large national healthcare services company. Earlier in her career, she served as a management consultant at McKinsey & Company and worked in various finance leadership roles at American Airlines, Sabre, and General Motors. Fraser earned her bachelor’s degree in business administration from the University of Washington and an MBA from the University of Michigan.

“When we started Welbe, we started with the belief that we have to care for each other before we can care for our participants, so our team has always been the center of our culture and focus,” said Si France.  “With Cathy, who led dynamic people functions at Mayo and Tenet, we’re making a significant commitment to putting our people first.”

About WelbeHealth

WelbeHealth is a physician-led organization founded in 2015 that coordinates senior care, including all medical and dental care, physical and occupational therapy, transportation to medical appointments, meals and personal care services, in a fully coordinated program. WelbeHealth teams close the loop on comprehensive care to keep the most vulnerable seniors living safely in their own homes. WelbeHealth delivers these services through the Program of All-Inclusive Care for the Elderly (PACE), a Medicare and Medicaid program. WelbeHealth operates four programs across California, including the cities of Stockton, Modesto, Pasadena, Long Beach and Fresno. WelbeHealth served more than 1,000 seniors in 2021.  For more information, please visit welbehealth.com.

WelbeHealth Executive Director Mindy Wilds Honored with Prestigious PACE Award

Mindy Wilds, executive director of WelbeHealth’s Fresno Program of All-Inclusive Care for the Elderly (PACE), was recently honored by the National PACE Association (NPA) with the prestigious Marie-Louise Ansak Award.

The Marie-Louise Ansak Award, named after the founder of PACE, recognizes the ingenuity, hard work and sacrifice of an individual PACE program employee who has worked to improve the quality of life for one or more frail older persons during the past year.

“We are proud to recognize Mindy with the Marie-Louise Ansak Award,” said Shawn Bloom, president and CEO of the NPA. “Mindy earned this high honor through epitomizing the innovative team player that is core to delivering PACE.”

Wilds received the award at the October NPA Annual Conference in Seattle.

“I love this model of care because we can think outside the box and provide common sense solutions for our participants and their families,” said Wilds.

Mindy Wilds with Award
Mindy Wilds with the Marie-Louise Ansak Award

Wilds joined WelbeHealth in February 2021 as the executive director of WelbeHealth’s Fresno Center, which provides medical care, physical therapy, social and recreational activities, meals and nutritional counseling, transportation and other support services to PACE-eligible medically frail seniors age 55 and over.

“Mindy is a model for all of us. Her tireless commitment and dedication to seniors in our communities enables them to thrive and live longer with greater connection, vitality and meaning,” said WelbeHealth CEO Si France, M.D.

About WelbeHealth

Founded in 2015, WelbeHealth provides comprehensive home-based medical and social services to more than 1,500 vulnerable seniors across California, including the cities of Stockton, Modesto, Pasadena, Long Beach and Fresno. The company recently became the first Program of All-Inclusive Care for the Elderly (PACE) provider to convert to a public benefit company, meaning it is obligated to take into consideration the concerns of all stakeholders while prioritizing corporate responsibility and sustainability.

An alternative to nursing homes, PACE is a Medicare and Medicaid program that helps keep people in their homes and communities. PACE programs are proven to reduce depression, lower hospitalizations, decrease rehospitalizations, reduce nursing home admissions and improve preventive care, according to recent data from the National PACE Association.

For more information, please visit welbehealth.com.

Contacts

Jennifer Wezensky
jennifer@jwprmarketing.com

WelbeHealth center in Modesto

WelbeHealth Modesto Center Opens to Serve Medically Frail Seniors

Physician-led healthcare organization WelbeHealth and Northern California-based healthcare network Sutter Health have opened a new center in Modesto that serves medically frail seniors.

Located at 1224 Scenic Drive, the center is designated a Program of All-Inclusive Care for the Elderly (PACE) alternative care setting. Integrated with WelbeHealth and Sutter’s PACE center in Stockton, the new Modesto location provides day services to PACE-eligible medically frail seniors age 55 and over. The center, which will employ more than 100 full- and part-time employees when at capacity, features:

  • Physical and occupational therapy
  • Personal care and supportive services
  • Meals and nutritional counseling
  • Recreational therapy
  • Access to in-home care and mobile clinic

The new Modesto center addresses a community need, since only a fraction of the over 3,000 PACE-eligible seniors in Stanislaus county are receiving PACE services, according to a WelbeHealth analysis of U.S. Census data and the Medi-Cal Managed Care Enrollment Report.

“WelbeHealth was built on the mission of serving our most vulnerable seniors with greater quality and compassion in underserved communities,” said WelbeHealth CEO Si France, M.D. “As the first provider of PACE services in Modesto since 2019, we are proud to complement our care with a beautiful facility.”

PACE is a national Medicare and Medicaid program that helps keep seniors living in their own homes instead of nursing homes. PACE programs are proven to reduce depression, lower hospitalizations, decrease rehospitalizations, reduce nursing home admissions and improve preventive care, according to recent data from the National PACE Association.

“We are proud to partner with WelbeHealth to enrich the lives of seniors, their caregivers and the broader community,” said Christopher Stanley, M.D., Sutter Health’s chief population health officer. “WelbeHealth shares our commitment to high-quality, community-based healthcare services that help frail older adults anticipate problems and prevent hospitalization or early entry into a nursing home.”

Todd Smith, M.D., foundation area CEO for Sutter Health in the South Valley, said that the importance of good health for aging seniors can’t be underestimated.

“Creating greater access to comprehensive home and community-based healthcare services helps seniors achieve their best health and maintain their independence,” Dr. Smith said.

In addition to the new Modesto center, WelbeHealth has locations in Stockton, Pasadena, Long Beach and Fresno. More than 1,500 seniors were served in 2021. Sutter Health is a not-for-profit integrated health network that serves more than 3 million people in 22 California counties.

Contacts

Jennifer Wezensky
269-274-4071
jennifer@jwprmarketing.com

General Counsel

Blaire Bernard Joins WelbeHealth as General Counsel 

MENLO PARK, CALIF.—Physician-led healthcare organization WelbeHealth today announced that veteran healthcare law attorney Blaire Bernard has joined its leadership team as general counsel. 

Bernard has focused her 20-year legal career on supporting providers whose mission is to expand access to value-based care. Most recently she was general counsel at Iora Health and after Iora Health was acquired by One Medical, she served as senior counsel and compliance officer. She earned a bachelor’s degree from Dartmouth College and a law degree from Boston University. 

“We’re thrilled to have Blaire join our executive team,” said WelbeHealth CEO Si France, M.D. “She is a seasoned value-based care executive and a collaborative mission-driven team player. This is even more important as we continue our focus on clinical and care excellence as a public benefit company.” 

Bernard will lead WelbeHealth’s legal and compliance functions, partnering with executive and operational leaders to execute the company’s mission of bringing PACE to communities in need.  

WelbeHealth recently became the first Program of All-Inclusive Care for the Elderly (PACE) provider to convert to a public benefit company, meaning it is obligated to take into consideration the concerns of all stakeholders while prioritizing corporate responsibility and sustainability. An alternative to nursing homes, PACE is a Medicare and Medicaid program that helps keep people in their communities. 

Founded in 2015, WelbeHealth provides comprehensive home-based medical and social services to vulnerable seniors across California, including the cities of Stockton, Modesto, Pasadena, Burbank, Long Beach and Fresno. For more information, please visit welbehealth.com.   

Doctors and nurses coordinate hands

WelbeHealth Becomes First Program of All-Inclusive Care for the Elderly (PACE) Provider to Convert to Public Benefit Company Status 

FOR RELEASE: IMMEDIATE

DATE: 6/29/2022

WelbeHealth Becomes First Program of All-Inclusive Care for the Elderly (PACE) Provider to Convert to Public Benefit Company Status  

MENLO PARK, CALIF.— Physician-led healthcare organization WelbeHealth recently became the first Program of All-Inclusive Care for the Elderly (PACE) provider to convert to a public benefit company (PBC).

Founded in 2015, WelbeHealth is a leading California PACE provider. An alternative to nursing homes, PACE is a Medicare and Medicaid program that helps keep people in their communities. WelbeHealth provides comprehensive home-based medical and social services to vulnerable seniors across California, including the cities of Stockton, Modesto, Pasadena, Burbank, Long Beach and Fresno.

In joining other companies that have become public benefit companies, including Patagonia, Seventh Generation and Vital Farms, WelbeHealth is exemplifying its commitment to helping seniors thrive and live longer, said WelbeHealth co-founder and CEO Si France, M.D. 

“The seniors we serve are the elders of their communities and families,” Dr. France said. “By helping them thrive, they can live longer lives with greater connection, vitality and meaning. We’re converting to a public benefit company to ensure that our mission and purpose are protected for generations to come.” 

Public benefit companies are obligated to take into consideration the concerns of all stakeholders, not just shareholders, prioritizing corporate responsibility and sustainability. For WelbeHealth, this means participants, their families and caregivers, employees, and the broader community.  

“Both our independent board and management team wanted to formalize WelbeHealth’s commitment to its mission, clinical quality and positive community impact,” said WelbeHealth Board of Directors member Robert Margolis, M.D., founder of the Duke-Margolis Center for Health Policy. “By converting to a public benefit company, WelbeHealth is demonstrating its commitment to operating responsibly, sustainably and in the interest of all stakeholders, both now and in the future.”

This commitment to the greater good is not new. In fact, WelbeHealth was lauded for its elder care during the pandemic. A case study conducted by UC Berkeley found that WelbeHealth had a death rate more than 1.5 times lower than other PACE organizations and almost five times lower than nursing homes while, despite serving patients in some of California’s most impacted counties.  

“As the pandemic came in waves, WelbeHealth mobilized not only to vaccinate its own participants but to also vaccinate thousands in the greater community, which had an exponential impact on saving lives,” Dr. France said. “We want to take full responsibility for our part in making the world a more compassionate, loving place.” 

About WelbeHealth 

Founded in 2015, WelbeHealth is a physician-led organization that coordinates senior care, including all medical and dental care, physical and occupational therapy, transportation to medical appointments, meals and personal care services. WelbeHealth teams close the loop on comprehensive care to keep the most vulnerable seniors living safely in their own homes. WelbeHealth delivers these services through the Program of All-Inclusive Care for the Elderly (PACE), a Medicare and Medicaid program. WelbeHealth operates four programs in California:  Stockton/Modesto, Pasadena/Burbank, Long Beach and Fresno. For more information, please visit welbehealth.com

Courage to love: Realizing a future without nursing homes

Three alums reunite to improve the lives of the frailest and most vulnerable senior citizens through participation in a U.S. health care program.

By The McKinsey Alumni Center

 –  When Si France, M.D. (SVO 08-12), Vaneesh Soni, M.D. (DET, DBI, SCA 99-15), and Matt Patterson, M.D. (SVO 09-12) first met, they were streamlining hospitals. “At McKinsey, we were these three doctors who wanted to do good value-based care,” says Si.

They reunited to do just that by founding WelbeHealth, which enables frail and elderly senior citizens to continue living in their homes and communities through participation in a U.S. government program known as PACE (Program of All-Inclusive Care for the Elderly).

Matt, who grew up in a Navy family and became a doctor for the Navy SEALs, is Welbe’s President and clinical operations leader. Vaneesh is the team’s resident strategist and Chief Growth Officer, driving Welbe’s mission-driven expansion. Si is the out-of-the-box entrepreneur who has co-founded two health care startups and is leading Welbe as the CEO. Armed with complementary leadership profiles, an interdisciplinary team, and a shared values system, Welbe aspires to realize a future where seniors can receive dynamic care without the need for nursing homes.

We sat down with the trio to discuss Welbe’s care services, purpose-driven culture, and their response to the COVID pandemic, which saw them at the center of one of the hottest infection zones in the world.

Tell us about Welbe’s culture.

Vaneesh: We invest as much energy into organizational health and culture as our strategy and business model. We don’t want to be a company with the best strategy but have poor performance overall because we have a toxic culture. Service to seniors is our common intent, and clinical quality is our North Star. Our growth rate is tied to the pace at which we can ensure consistent, high-quality care.

Si: We started the company to create a culture based on a mission and values system different from what is more traditional in Silicon Valley. We knew that it would take courage to build a values-based company and that we would need to view our patients through the eyes of their loved ones. We called this our “courage to love” culture, and it permeates everything we do, whether we’re interacting with our team or interacting with our patients.

Matt: Our core values of courage to love, pioneering spirit, and shared intention are the unquestioned foundation for ensuring that we have healthy teams, our people feel uniquely cared for, and we serve vulnerable seniors with a commitment to clinical excellence. What excites me is that we’re bringing consciousness and love as a priority within our business model. We want to normalize individuals being able to show up as their authentic selves and engage at that level with each other and those that they serve.

 

Tell us about Welbe’s care model. What distinguishes it from other services?

Si: Our care model is called “PACE,” Program of All-Inclusive Care for the Elderly. We provide 24/7 medical and social services to frail seniors to stay healthy, live at home, and stay out of a nursing home. When people enroll in PACE, their life expectancy goes up by one-third, clinical scores improve, and it even saves taxpayers $10,000 per patient annually.

Vaneesh: PACE has an 80% reduction on depression scores nationally. As both the health plan and the provider of services, we emphasize the social and the human components of care. We can greenlight things that are truly in the best interest of each participant, medically, socially, as well as things that bring joy in life.

Matt: PACE has been around for decades, but we’re changing the landscape by bringing these services and outcomes to those who would otherwise not have them, in areas of the country that are in significant need, and at a speed and scale that previously has never been done before.

 

How did Welbe respond during the pandemic?

 

Si: We’re the first organization to do bubble-style testing, where our nurses would take a COVID test before entering anyone’s home. We were the first non-hospital owned program of our kind to vaccinate all of our team and patients. We also partnered with counties across California and vaccinated 2,000 frail seniors and front-line health care workers in the community who had nothing to do with Welbe.

Vaneesh: We closed our centers two weeks before the state of California announced the lockdown. Within four days of the lockdown, we had deployed a tablet-based, home-and-remote care model. I think the proudest moment was helping rescue seniors out of nursing homes. Many seniors in nursing homes don’t require 24/7 care; they are in a nursing home because they don’t have access to stable housing. We partnered with housing institutions to find them stable and safe housing, and provided care for them in those environments.

Matt: In the first year of the pandemic, COVID-19 mortality rates for nursing home individuals were upwards of 14%. The U.S. national average of PACE programs was about a third less, and Welbe was about a 10th. Our outcomes were 10x better than nursing home environments, and we were in two of the hottest areas for COVID infection in the entire world at various points. It’s a testament to the fact that we were very bold and decisive in deploying technology enablement, best-in-class rapid testing, early adoption of vaccination, and mass administration of vaccinations.

 

What impact did McKinsey have on you?

Matt: It was a profound tipping point in my journey, not the least for which I met two of my greatest friends in Si and Vaneesh. McKinsey also introduced me to the effectiveness of the remote working model by showing that I can have a laptop and work from anywhere in the world. Welbe’s technology footprint was built around a similar remote model that allowed us to be well-positioned and decisive during the pandemic.

Vaneesh: We rely on our McKinsey experiences or problem-solving daily. McKinsey showed me that it’s possible to deliver amazing impact and still do well financially and grow. Through different engagements and geographies, I gained exposure to different health systems and clinical models.

Si: It’s impossible to underestimate McKinsey’s impact on my career, from relationships, to learning how to build a principles-driven organization and how to think and communicate effectively. McKinsey gave me the tools to serve on a macro level. It was the best career decision I could have made to launch my career.

 

What does Welbe’s mission mean to you?

Si: What it means for me is a force for good in the world. Through the work we do and through our culture, we are caring for people beyond ourselves. To give an example, we had a patient who lived at home alone with her dog. She fell, broke her pelvis, was in the hospital, and as she recovered, she got a call from the local shelter saying, “Your neighbors reported an abandoned dog. We’re going to need to put it down.” She called our licensed vocational nurse at the center, and our LVN went down and rescued the dog and found a place for it while she recovered. Our patient said that the minute she learned of the rescue, she started going to physical therapy to get better as quickly as possible and get home to her dog.

 

Matt: My mom is a vulnerable senior with chronic mental illness. I have seen the failures of traditional health care models in senior care. What WelbeHealth’s mission means for me is that we advocate for those in our culture who are at the wrong intersection of not being valued and most at risk. It’s individuals who have very little social capital who are being left behind. Through our service, they can experience and share the love and wisdom that they have within them and have gained over their lifetime.

Vaneesh: What it means for me is service. In the Indian culture, we have different phases of our life: a phase for education, a phase for building a family, a phase for working, so on. There’s also a phase for service to others – called Seva.

Welbe is our service to our seniors. Our seniors, especially in the Indian culture, have the most wisdom and should be the most revered. When Matt, Si, and I reunited after McKinsey, we determined that Welbe would be governed by a profound sense of purpose to serve the most frail and vulnerable seniors and ensure they are embraced and cared for with dignity and respect so that they can age gracefully in the community or their own homes.

(This article is published in the McKinsey Alumni Center here.)

Home Health Care News: Despite Formidable Challenges, PACE Leaders Keep Expansion Dreams Alive

By Joyce Famakinwa

The Program of All-Inclusive Care for the Elderly (PACE) concept has gained significant business and policy momentum over the past several months, with recent research also highlighting just how successful programs were at avoiding COVID-19 deaths compared to other care settings.

Despite that traction and the model’s clear benefits, PACE still faces a long list of formidable growth barriers.

An alternative to nursing homes, PACE is a Medicare and Medicaid program that helps keep people in their communities. Oftentimes, programs are run out of community-based centers with the support of in-home care providers and their staff.

“Embedded in this model is that the PACE program also addresses the social determinants of health for the enrollees and wraps around this care with a very comprehensive interdisciplinary care team,” Jade Gong, founder and principal of consulting firm Jade Gong & Associates, told Home Health Care News.

At any particular time, 95% of PACE enrollees are living in the community, with about 5% in nursing homes, according to Robert Greenwood, senior vice president of public affairs at the National PACE Association.

“This is pretty remarkable, given that you have to be eligible for nursing home care before you can even enroll in PACE,” he told HHCN.

Based in Alexandria, Virginia, the National PACE Association is an industry advocacy group that focuses on federal and state policies to support the financial viability of the PACE model.

Broadly, the majority of PACE participants are eligible for both Medicare and Medicaid. PACE operators receive a set monthly payment for each participant. Typically, PACE is both payer and provider.

“Having a capitated payment really helps the PACE model because we’re able to emphasize providing primary and preventive care over the things that are really expensive, which are emergency room visits, hospital visits or permanent placement in a nursing home,” Greenwood said.

While the PACE model has been attracting interest over the past few years, the COVID-19 emergency played a major role in ramping up this attention, according to Gong.

“The model just performs so well under COVID,” she said. “There are many different kinds of providers — nonprofit, for-profit, housing — that are interested in PACE or relationships with PACE programs.”

If one provider exemplifies the performance success the model saw amid the public health emergency, it’s WelbeHealth, a Menlo Park, California-based operator of PACE programs.

Overall, WelbeHealth and the PACE community had lower death rates than their nursing homes counterparts, research has found.

In fact, the national PACE COVID-19 death rate was 3.8%, compared to 11.8% in nursing homes. WelbeHealth’s COVID-19 death rate was 2.4%, according to a recent case study conducted by UC Berkeley.

For context, WelbeHealth serves LA and Central Valley, which have both been COVID-19 hotspots at times.

“These were places where crematoriums listed their pollution caps because they had too many bodies piling up,” Si France, founder and CEO of WelbeHealth, told HHCN. “This is where paramedics were asked to start rationing care. The hospitals were full, and they had to fill up their parking lot pop-up units. That was the nightmare context where we had these dramatically lower death rates.”

Over the years, WelbeHealth has seen growth as the organization aimed to serve underserved markets in California. The company added a Fresno program in late 2020 and will serve about 1,000 participants by the end of the year.

“We ranked California cities by highest unmet need, and started working on serving them, in order, beginning with Stockton and Pasadena in 2019, then Long Beach in 2020,” France said. “None of these communities had any PACE services despite having a high need. You had no access to this program that increases quality of life and length of life.”

France noted that PACE enrollees experience an 80% reduction in depression and generally have a higher life satisfaction. They also tend to live longer under the comprehensive and interdisciplinary care model.

Despite strong outcomes from many PACE providers, such as WelbeHealth, there is still room for expansion.

In total, there are 140 PACE organizations operating 272 PACE centers in 30 states, serving over 56,000 participants, according to the National PACE Association.

One of the major barriers to furthering PACE expansion is how high the cost of entry can be for new operators.

“When an organization wants to look at developing a PACE program, it’s not just building the center, hiring the staff, having the right information systems, and leasing or buying the vans to provide transportation,” Greenwood said. “Part of the startup costs is operating in those initial months when you don’t have a big enough enrollment to bring in the revenue that really covers all your expenses.”

Another roadblock is the PACE application process, which requires the state to develop a rate-setting methodology for anyone who’s a Medicaid eligible PACE enrollee. States must also agree to take on certain oversight responsibilities.

“One of the things that really stops a provider from being able to develop PACE is the willingness of the state they’re operating in to support that development,” Greenwood said.

In an effort to drive PACE expansion, Sen. Bob Casey, a Democrat from Pennsylvania and chairman of the Senate Special Committee on Aging, introduced the “PACE Plus Act” in April.

The legislation has received a warm reception from industry insiders for being comprehensive and attempting to cut through red tape.

“I have some sense of optimism that we’re going to get some real traction on the bill this year,” Gong said. “I have talked to some of the senators in states where I have clients, and there’s tremendous interest in seeing PACE expansion.”

If passed, the PACE Plus Act would make room for the creation of new PACE programs and the expansion of current ones through federal grants. The legislation also encourages non-PACE states to take up the model by providing incentives.

Additionally, the legislation would lessen the bureaucratic burden that growing PACE programs face while also providing technical assistance resources.

Another bright spot has been various states’ willingness to consider the PACE model, according to Greenwood.

“States have been looking more closely at how they want to provide long-term care supports and services in the future,” he said. “They’re looking at what else they can do beyond offering nursing home residential care. I think they’ve become a lot more open to supporting PACE as a way to provide more healthy community-based services.”