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UC Berkeley Study Reveals WelbeHealth’s Rapid Adaptation To COVID-19 Eldercare Yielded Exceptional Results And Saved Lives

As policy momentum grows toward home and community-based services, study recommends that policy choices focus on the Program of All-Inclusive Care for the Elderly (PACE), and it’s 45-year track record of success in serving the most complex elderly patients.

SILICON VALLEY, Calif., July 14, 2021 — A new study from UC Berkeley’s Berkeley Roundtable on the International Economy (BRIE) features WelbeHealth in a case study illustrating how this California eldercare PACE provider responded early and decisively to the COVID-19 crisis with exceptional results.

“By rapidly transforming its care model, WelbeHealth had exceptional results: as COVID-19 cases rose across the country — and in particular within nursing home populations — WelbeHealth did not have a single COVID-19 death during the first 8 months of the pandemic. The first WelbeHealth loss from COVID-19 occurred on November 21, 2020 and 10 WelbeHealth participants died of COVID-19 since the beginning of the pandemic.”

-UC Berkeley

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Welbehealth: Case Study of Adapting PACE Under COVID-19

Key findings:

  • WelbeHealth and the PACE community overall had lower death rates than nursing homes; the national PACE COVID-19 death rate was 3.8%, nearly one-third the 11.8% death rate in nursing homes. WelbeHealth calculated a death rate of 2.4%.
  • WelbeHealth acted early and decisively to minimize exposure with an Incident Command response strategy, dispersing tablets for telehealth visits, PPE, thermometers, food, medication, and other essentials into participants’ homes, and providing nearly all care remotely, which proved effective.
  • PACE’s capitated payment model moves the risk from payor to care provider, aligning incentives and encouraging innovation and efficiency in keeping patients well.
  • Technology provided an important amplification to PACE’s model of care — it allowed for regular check-ins and informed decision-making on care needs. However, the social aspect of the PACE day center cannot be replaced by technology, and it is clear that in-person visits are vital.
  • With America’s senior citizen population set to double by 2040, the demand for long-term care will skyrocket. The pandemic underscored that work must begin now to meet the needs of present and future vulnerable elders.
  • Existing home and community-based services (HCBS) such as PACE demonstrated profound success during the pandemic leading to fresh momentum among policymakers to expand these options further.

PACE’s person-to-person, fully integrated approach maintains the participant’s highest level of independence and quality of life[i]; PACE participants experience an 80% drop in rates of depression after joining.[ii] At a time when America is searching for a better way forward in eldercare, PACE is a proven approach for this vulnerable group.

 

“While PACE has a 45-year track record of success, it remains optional in Medicaid while nursing home benefits are required — it’s time for every vulnerable elder in the country to have access to this gold standard of long-term care,” said Elizabeth Carty, Chief Regulatory Affairs Officer of WelbeHealth.

 

Many PACE participants reside in medically underserved areas like San Joaquin County, California, where WelbeHealth’s creative problem-solving and speed to action kept seniors safe in their homes when resources for the elderly were relatively scarce.

 

“As other healthcare organizations were assessing the potential impact and spread of the pandemic, the WelbeHealth team had already taken its crisis response to the next level, ” said Amy Shin, former CEO of Health Plan of San Joaquin. “I was impressed with how nimbly this team charted out a plan not only to keep seniors safe and vaccinated but to vaccinate the community as well. This study’s findings should alert legislators that this style of home and community-based services is the ideal model of care for frail seniors.”

 

What is PACE?
PACE (Program of All-Inclusive Care for the Elderly) serves low-income seniors who meet their state requirement for nursing home level care allowing them to live independently in their own homes and communities while receiving fully coordinated medical and dental care, physical and occupational therapy, transportation, meals, day programs, home care assistance and more, managed by an 11-person integrated care team. The “one-stop-shop” PACE day centers are the hub of the program, offering seniors a pleasant place to receive care, socialize and enjoy meals within a state-of-the-art facility.

About WelbeHealth
WelbeHealth is a physician-led healthcare organization that provides seniors with high-quality, compassionate care so they can live in their own homes and communities rather than a nursing home. To accomplish this, WelbeHealth uses the PACE (Program of All-Inclusive Care for the Elderly) model. WelbeHealth currently operates four programs in the Stockton/Modesto, Pasadena/Burbank, Long Beach, and Fresno communities of California.


[i] Center for Consumer Engagement in Health Innovation, “Care That Works: Program for All-inclusive Care for the Elderly.” https://www.healthinnovation.org/resources/publications/care-that-works-pace

[ii] National PACE Association, “COVID Data Demonstrates That the PACE Model Is Safer Than Nursing Home Care.” https://www.npaonline.org/about-npa/press-releases/covid-data-demonstrates-pace-model-safer-nursing-home-care

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TIME MAGAZINE: COVID-19 Exposed the Faults in America’s Elder Care System. This Is Our Best Shot to Fix Them

June 15, 2021 (Time Magazine) – When COVID-19 hit the United States, nursing homes in Washington State took the first hit, producing deadly outcomes for older adults. Conditions within long-term care facilities enabled a harrowing spread of any pandemic, let alone a novel coronavirus. Compounding on this, leaders within institutional care were slow to respond when it arrived.

The plight of residents in long-term care facilities across the United States is detailed in a report by Abigail Abrams from Time Magazine. It begins with individuals living at Life Care Center in Kirkland, Washington, in late February 2020 where COVID-19 killed dozens in just a few weeks.

The shocking death rate created a sense of panic and by early March the families of those living within Life Care Center held a press conference appealing to the public on behalf of their loved ones.

“Our families are dying. We don’t know what to do. Our calls for help aren’t working,” said Kevin Connolly, whose father-in-law lived in the facility. “We have limited resources to battle this disease, and I think somebody somewhere decided that this population of people wasn’t worth wasting resources on.”

Nursing homes vs infection

Many nursing home residents live in shared rooms and rely on staff who tend to numerous patients and who often work at various other facilities. The industry’s low pay and long hours make for high turnover. These characteristics can create a lack of consistency in controlling the spread of infection.

The nursing home industry is losing occupancy rates, workers, and money. The long-term care industry could lose an estimated $94 billion between 2020-2021 due to the costs involved in both fighting the pandemic and losing occupancy, according to The American Health Care Association and National Center for Assisted Living (AHCA/NCAL).

America is aging rapidly. According to the Census Bureau, around 10,000 Americans turn 65 every day. Most people want to age at home rather than in an institution. Still, people who qualify for Medicaid and Medicare have little to no choice in where they receive long-term care after reaching old age. Governments in many states mandate that they enter long-term care facilities even when home-based care services are available.

In many cases, when a person does not qualify for government-funded care or chooses to avoid mandated care in a nursing home, a family member must often forfeit a job to take on the responsibility of caregiving. And if no one in the older adult’s circle of support can provide that care, paid home based care is challenging to find due to worker shortages. Many workers are leaving the historically low-wage industry, according to the Bureau of Labor Statistics.

Policy helps pave the way to home and community-based care.

Policy momentum is growing toward home and community-based care for the elderly across the nation. One home-based care program available to Medicaid/Medicare recipients has a 45-year proven track record of success and operates in more than 31 states. PACE (Programs of All-Inclusive Care for the Elderly) saves the government money while offering a high-touch, team-based approach to eldercare for people 55 years or older who qualify for nursing home level care.   It receives a payment per participant to provide medical care and dental care, day center programs, meals, home health aides, and many other services to keep seniors safe and living in their own homes and communities. PACE aims to keep this elderly population out of hospitals and nursing homes while incentivizing a flexible, creative, team-based approach to care. On average, states pay PACE programs 13% less than the cost of other Medicaid services.

“The nature of payment provides significant flexibility, as well as really strong incentives for PACE organizations to really proactively monitor and get out in front and address existing and emerging health needs,” says Shawn Bloom, president, and CEO of the National PACE Association.

Data collected during the pandemic show that seniors enrolled in PACE contracted COVD-19 at just one-third the rate of those in nursing homes, according to the National PACE Association.

The push for greater government funding for programs like PACE is growing. President Biden’s proposal to spend $400 billion on home care over the next 4 years could pave the way toward boosting access to more Americans. And proposed legislation in California, Assembly BILL (AB) 540, would allow eligible seniors to be automatically informed about PACE right along with other Medicaid and Medicare options.

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