Tabula Rasa HealthCare (Nasdaq: TRHC) — a provider of data-driven technology solutions — continues to tout the Program of All-Inclusive Care for the Elderly (PACE) model as an avenue for itself and home-based care to grow.
With at-home care and medication usage focuses, Tabula Rasa sees PACE as a major part of senior care’s future. The Moorestown, New Jersey-based company believes engagement in the program will continue increasing as well.
An alternative to institutional care, PACE organizations leverage home- and community-based care to serve individuals dually eligible for Medicaid and Medicare.
What drew Tabula Rasa to the program in the first place is its risk-bearing structure, Dr. Orsula Knowlton, the president and co-founder of Tabula Rasa, told Home Health Care News.
“They’re fully at risk for anything that happens to that individual. It’s the most at-risk model in the health care system,” Knowlton said. “So [these organizations] are really incentivized to take care of that individual, no matter what it takes.”
That means if there’s a fall risk, fixing stairs is a worthwhile investment, both for the senior’s safety and for the PACE organization’s bottom line.
It’s the same with medication risk, Tabula Rasa’s primary focus. The company leverages proprietary tech to delve deeper into what a senior’s medications are — and how they can interact with each other.
“We found these incentives attractive,” Knowlton said. “In PACE, they’re so aligned with what we were trying to do in reducing drug effects. They are incentivized to invest in partners — in particular, pharmacy partners — to support them to avoid hospitalizations, extra days in the hospital and readmissions.”
Over 10 years, Tabula Rasa has supported PACE organizations and helped multiple clients save people from having negative outcomes, the executive added.
Tabula Rasa announced Monday that it had seen PACE enrollment accelerate throughout the first half of 2021, with the second quarter exceeding records for net enrollment.
Currently, nearly 140 PACE programs serve around 55,000 patients across 30 states, according to the National PACE Association. Yet over 2 million Americans qualify for the program, leaving the penetration at about 3%.
COVID-19 made more Americans consider keeping their loved ones at home. That fact, plus a largely untapped PACE market, has convinced many health care organizations that big opportunities lie ahead in the program.
States, as a reaction to institutional failures during COVID-19, are also looking into expanding their PACE programs.
California and Florida, for instance, are weighing legislative action to increase access to PACE. Florida, in particular, is striving to set aside $73 million for 3,400 additional PACE participants, which would represent a 50% increase in enrollment for the state.
“There’s certainly a place for nursing home care,” Knowlton said. “However, for people who can maintain their residence in the community, they really should. I think that we should try to keep people in their homes or with their families, to reduce their risk, and to improve their quality of life. There’s just so many benefits to that.”
The 10% federal increase to home- and community-based services included in the American Rescue Plan is a tailwind, as it represents $13 billion extra headed towards caring for seniors in those settings.
The PACE Plus Act, introduced by U.S. Senator Bob Casey (D-Pa.) in April, also could have a positive effect on the program.
“With more than 800,000 people on waitlists to receive home- and community-based services, we must do more to provide access to supportive services for those wishing to remain at home as they age,” Casey said in a statement. “I introduced the PACE Plus Act to strengthen the PACE program — which offers comprehensive care and wraparound services that result in people experiencing fewer hospitalizations and visits to the emergency room, as well as reduced caregiver burden.”
As the Biden administration aims to improve home-based care’s infrastructure, Tabula Rasa sees PACE expansion as a natural extension of that.
“We see PACE and home- and community-based services all being a part of that,” Knowlton said. “And then the PACE Plus Act is also a tailwind. It might be the first iteration of something that looks at PACE being a federal opportunity, as opposed to a state-based opportunity.”
Between the legislative tailwinds and increased demand, Knowlton also believes that more home-based care agencies should get involved, especially after PACE turned more toward home-based care during the COVID-19 crisis.
“There is such an opportunity for home care organizations to consider PACE in the markets where they currently exist,” Knowlton said. “I know that there are several already offering these services, … and that is certainly something that they may want to consider, as we really see PACE as the best model for individuals aging in place.”
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