welbehealth Archives - WelbeHealth

Posts

Meeting Senior’s Oral Health Needs Where They Live

WelbeHealth is providing flexibility for dental professionals as part of its commitment to improving the lives of seniors and expanding opportunities for its team members.

By: Susan McLearan, BSDH, MS, RDHAP

November 21, 2021 – All Baby Boomers in the United States will be over 65 years of age by 2030 – making up more than 20% of the population. And just 30 years after that, those 85 years and older will triple, according to the US Census Bureau . This growing group fights an uphill battle to access the vital preventive and restorative oral care they need to maintain their health. Lack of personal mobility, transportation, and dental care insurance upon retirement, combined with often challenging living circumstances, can make access even more difficult. While provisions to address the problem were added to California’s historic Master Plan for Aging, they do not offer real solutions that can handle the enormity of the problem. However, programs exist in California that are turning things around by offering hygienists the chance to provide care in a flexible work environment. One of those programs is commonly referred to as PACE.

What is PACE?
PACE stands for Programs of All-Inclusive Care for the Elderly. It is a Medicare and Medicaid-funded program for adults 55 and older who live with chronic illnesses and are eligible for nursing home level care. The goal of PACE is to keep seniors living independently in their homes and communities. An 11-person team provides medical and dental care, physical and occupational therapy, transportation, meals, day programs, and home care assistance. The “one-stop-shop” day centers provide a welcome venue for seniors to receive care, socialize and have meals. PACE programs act as both the payor and the provider. This creates an incentive for these organizations to apply innovation and efficiency in keeping patients well, including added flexibility for dental care access. The all-encompassing approach to a more independent style of living produces 80% lower depression rates after nine months of enrollment and also leads to 98% of participants’ loved ones recommending PACE.

What is PACE in California?
PACE began in San Francisco more than 45 years ago and was the brainchild of Dr. William Gee and social worker Marie-Louise Ansak. They saw the need for alternatives to nursing homes and assisted living facilities so seniors can live healthier lives independently. Currently, there are 65 PACE programs in California serving more than 12,000 participants who are primarily dually eligible for Medicare and Medicaid.
For people with comparable needs, PACE is 42% less costly than institutional care, and will save California taxpayers $131 million in 2021. As part of becoming a PACE program, an organization such as “WelbeHealth” must outline its plan for providing at least the minimum required services. While dental services are listed, they are not among the minimum requirements on site.

What is WelbeHealth?
WelbeHealth provides full-service health care and personalized support to help seniors age well at home and in their community. The company currently operates four PACE programs in Stockton, Fresno, Pasadena, and Long Beach, with continuing expansion across California. Through a contract with a Registered Dental Hygienist in Alternative Practice (RDHAP) in the Stockton area, WelbeHealth is providing flexibility for dental professionals as part of its commitment to improving the lives of seniors and expanding opportunities for its team members. In addition to flexible hours and mobile clinics, hygienists especially enjoy the program because they are included as part of a broader coordinated interdisciplinary care team, so they have complete transparency around the patient’s health status. The WelbeHealth RDHAP program will be described in detail in a future article.

What Could This Mean for Dental Hygienists?
Lisa Gildea, RDH, RDHAP, is newly contracted with WelbeHealth to provide hygiene services and works with a contracted dentist. Together they provide complete dental care to participants, most of whom have extensive dental needs because they have not had access to routine dental care for some time before enrollment.

Lisa Gildea, RDH, RDHAP in WelbeHealth dental operatory

The WelbeHealth center has a dental suite that Lisa uses for patients (called participants by the program) who may be driven to the site by Welbe’s transportation service. Due to potential exposure to COVID-19, WelbeHealth has taken extra precautions to ensure its participants stay safe and protected, including deploying a HomePACE model to provide services in participants’ homes or skilled nursing facilities. COVID 19 provided the incentive for WelbeHealth to develop mobile and portable dental services, which Lisa is spearheading with the disciplinary care teams. She treats patients whether they live in their own homes, intermediate care facilities, or skilled nursing facilities when needed. Also, in collaboration with the WelbeHealth outreach team, Lisa will participate in the coming Smile Campaign, set to launch in January 2022 to promote dental health.

While other PACE operators may increase their commitment to oral health, will other hygienists find similar opportunities to contract with them and use their skills on behalf of the elderly? Interested hygienists may wish to consult the Department of Health Care Services website to determine if nearby programs exist.  In our next issue, we will detail the experience of Lisa Gildea, RDH, RDHAP, part of the innovative team delivering services to this important population through the PACE/WelbeHealth program.

 

About the Author
Susan McLearan, BSDH, MS, RDHAP, is a career-long member of CDHA and has been a CDHA President. Currently, she serves as a Trustee and a member of both the Government Relations and Alternative Practice Councils. As a liaison to several governmental groups and oral health organizations, she advocates for the inclusion of oral health and dental hygiene providers in all areas of health policy.

 

(Originally published in CDHA – California Dental Hygienists’ Association Journal)

 

 

CDHA Journal Vol. 41 No. 2

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

READ THE STORY: 

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

Read more

mHealthIntelligence: California Provider Sees Telehealth as an Integral Part of PACE Programs

WelbeHealth President Matt Patterson says COVID-19 has taught the industry a good lesson on how to use telehealth, and it should be a permanent part of the senior care service.

By Eric Wicklund

 – A California-based healthcare provider is integrating telehealth into its PACE programs, saying the connected health platform improves its ability to provide value-based care for seniors in their own homes.

While the focus of PACE programs has been on in-person care, the coronavirus pandemic prompted many to shift to connected health to maintain contact with their patients. For WelbeHealth, that meant partnering with Grandpad to equip patients with senior-friendly mHealth tablets that allow them to connect with caregivers on-demand and access health and wellness resources online.

“COVID-19 introduced the need for us to pivot to telehealth,” says WelbeHealth President Matt Patterson. “And in the process, we have saved lives.”

WelbeHealth is one of hundreds of providers focused on the senior care market, many of which participate in the Centers for Medicare & Medicaid Services’ Program of All-inclusive Care for the Elderly (PACE) program. Developed by CMS roughly 30 years ago as a capitated model of care for dual-eligible beneficiaries (ninety percent are dual-eligible), it provides all necessary medical care, therapies, long-term care and services, meals, socialization, transportation, day center services, and activities.

There are currently 135 PACE programs in 31 states, enrolling between 50 and 3,000 patients, for a total of more than 54,000 seniors served. The programs are based in a care center and feature an interdisciplinary care team (IDT) of primary care physicians, nurses, therapists, social workers, dieticians, home care professionals, and others and offers a variety of services on-site and in the home.

PACE programs have traditionally shied away from telehealth, but COVID-19 changed that line of thinking. Now Patterson and his team are at the forefront of a new wave of care providers who want to make telehealth an integral part of the program.

“It’s an exciting opportunity to extend the reach of PACE (and) do more to improve and enrich the lives of our participants,” says Patterson, a former naval surgeon who served as president of digital health pioneer AirStrip before moving into the senior care space.

Telehealth gives PACE programs with WelbeHealth’s the ability to be there for seniors at any time, and to address issues that might not be addressed during in-person visits. That’s important at a time when, mostly due to COVID-19 restrictions, seniors are experiencing high rates of depression, anxiety, stress and substance abuse.

That point has been proven in the Grandpad project. According to a case study, seniors in the WelbeHealth program logged nearly 34,000 hours on the tablets – using both synchronous and asynchronous services – between March of 2020 and March of 2021, including more than 1,500 hours accessing mental health treatment. They also used the tablets to access medical care and exercises aimed at treating cognitive decline.

Patterson says emergency measures adopted by both state and federal governments during the COVID-19 public health emergency have enabled PACE programs to use telehealth more freely. He and his company have been lobbying state officials to make those freedoms permanent.

On the federal level, a bill introduced in March and now before Congress would ensure permanent coverage for audio-only telehealth services for Medicare Advantage and PACE programs, giving providers like WelbeHealth the freedom to incorporate phone calls and non-video telehealth platforms into care plans.

The benefits of connected care are numerous. On-demand access to care providers means seniors can go about their day knowing there’s someone always available should an emergency occur. They have instant access to health and wellness resources that go beyond what they’re getting when the nurse comes by for a visit. They can also collaborate more often on medication management, keep track of daily vital signs, or just talk to someone if they’re lonely or depressed.

Patterson says the pandemic is giving WelbeHealth and others the time to prove the value of connected health and to gather data and experiences to support permanent coverage.

That will be important. CMS has traditionally been very reluctant to expand telehealth coverage and has long argued that it needs evidence that these tools and platforms improve clinical outcomes and reduce wasteful expenses and unnecessary treatments. In short, they want proof.

“PACE is an ideal model for integrating high-touch and virtual care,” Patterson counters. And he wants to do more of that.

“Telehealth is definitely not a replacement (for in-person care), but it gives us more tools, and we want to use these tools for what our participants desire,” he says. “As an organization, we only do well when our participants do well. And they’re doing well.”

 

Click on the logo to view the article.

 

Why We Support California Assembly Bill (AB) 523: Because Lifting Regulatory Bottlenecks Saved Lives During Covid-19 Crisis

Why Assembly Bill 540 Must Pass: Because seniors have a right to know about the PACE option for home and community based care

WelbeHealth Administers First Shipment of COVID-19 Vaccines

LONG BEACH Dec. 31, 2020 – WelbeHealth is administering its first COVID-19 vaccines to its elderly participants this week, beginning at the organization’s center in Long Beach, California. The first seniors received their vaccinations on Wednesday, and additional vaccines will be administered next week.

WelbeHealth, a healthcare provider delivering integrated home-based care for frail seniors across California, received its first shipment of the vaccine earlier this week and rapidly deployed its plan to administer the injections to its highest-risk participants.

“This is a momentous occasion for our programs and our society. It’s essential that we all get vaccinated, not only for ourselves but for the safety and wellbeing of everyone in our communities,” said WelbeHealth President Matt Patterson, MD. “With each vaccine, we are literally saving the lives of our elders who have given so much to enrich our world.”

WelbeHealth provides care as part of PACE (Program of All-Inclusive Care for the Elderly), a longstanding Medicare and Medicaid program that enables older adults to live in the community instead of a nursing home.

At the onset of the coronavirus pandemic, WelbeHealth shifted to a remote home-based care model, providing each participant with an internet-connected WelbeLink computer tablet and delivering care in the home whenever possible. The program has a long track record of positive outcomes, including longer life expectancy and dramatically improved mental health and quality of life. The PACE model has proven dramatically safer for seniors during the pandemic, with 85-95 percent lower infection and mortality rates than nursing homes.

 

 

TAKING ACTION TO PROTECT OUR SENIORS DURING THE COVID-19 PANDEMIC

To our dear seniors, families, and caregivers,

As you know, the spread of coronavirus continues to escalate globally, nationally, and here in California. During these challenging times, I want you to know that our leadership teams have been working around the clock to implement a proactive clinical and operating model to keep our seniors safe and our team healthy.

We are taking bold, aggressive, and preemptive actions to maintain the health and well-being of our PACE participants and our team.

Pandemic Response Systems Implemented:

Our organization has been prepared to operate during a pandemic since long before the emergence of COVID-19. On March 13, we formally mobilized our emergency preparedness program and launched our Pandemic Incident Response Systems. These systems include a well-defined chain of command and pandemic-specific roles and responsibilities for our team, ensuring clear communication and enabling continued high quality of care for our participants.

Remote/At-Home Patient Care Launched:

As of March 16, our PACE participants are receiving nearly all their care remotely, at home. In addition to medical care, we continue to provide essential services to our seniors based on individual needs, including food preparation and delivery, medication delivery, and personal hygiene assistance.

Each participant has also been provided with a 4G LTE “WelbeLink” tablet with hardware and software specifically designed for use by seniors. Our care teams are using these tablets to maintain regular video communications with participants in the home.

Work from Home Mandated:

As of March 16, all WelbeHealth staff have been mandated to shelter in place and work from home unless otherwise assigned by our emergency response team. This mandate protects our participants and caregivers and ensures immediate containment of any single COVID-19 case.

COVID-19 Resources Ready:

We’re working closely with local, state, and federal health officials to ensure we have appropriate resources in place to care for our seniors. We are prepared to test participants and staff for COVID-19 when appropriate. In addition, we continue to monitor and comply with evolving government and CDC guidance.

My colleagues and I chose to work in healthcare out of a sense of calling—a desire to serve and contribute when it matters most. I’m grateful for the opportunity to serve you, and I assure you that our team will continue to make every effort to do the right thing and protect our seniors during this critical time.

Sincerely,
Si France, MD
CEO, WelbeHealth

To learn more about our PACE services, click here

How COVID-19 Spreads

How to Protect Yourself & Others

Social Distancing

Entrepreneur.com: How This Mission-Driven Change Agent Is Disrupting Healthcare

A doctor and entrepreneur shares how his team is changing eldercare.

Entrepreneur

– WelbeHealth Founder and CEO, Si France, MD was interviewed by Entrepreneur.com’s Jessica Abo about what motivated him to pave his own path to entrepreneurship.
Health Care Capitalist or Mission-Driven Change Agent? Check out what he has to say about pivoting from the success of the business-model-based GoHealth Urgent Care,  to something that was a force for good:
“I wanted to go create this organization where people weren’t resources in some kind of capitalist plan. We cared about people.”
With a focus on elder care, Si went on to create WelbeHealth, an operator of the Medicaid/Medicare PACE (Program of All-Inclusive Care for the Elderly).
PACE serves low-income, Medicaid/Medicare eligible, frail seniors by providing 11-person integrated care teams to each participant so that they can live independently in their own homes and communities while having full access to medical and dental care, meals, transportation, medication management, home health aides, adult day programs, and more. Teams who operate PACE, like Welbe, report an 80% average drop in depression rates after enrollment.
During COVID-19 it saved lives and its rapid response to the pandemic has been featured as a case study in the rapid deployment of telehealth during the lockdown, while still emphasizing the absolute importance of high-touch, in-person care.

Click on the logo to read the full story.