Strategies for PACE Participant Enrollment and Growth

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PACE is the ideal solution for many families. Their loved ones can age in place and are equipped with every tool needed, from transportation and medical care to socialization, meals, and beyond. But unfortunately, PACE is not as well-known in the industry as it should be. In fact, many PACE community members grimly joke that it’s healthcare’s “best kept secret”.

So, how can we overcome this obstacle? As a PACE organization, what can you do to expand your reach and increase your program’s enrollment? We’ve called in the experts, who have over 49 years of combined PACE experience, to share first-hand strategies that have proven beneficial to their own program growth.

Strategy #1: Recruit internal teams as promoters (from staff to participants)

PACE Southeast Michigan (PACE SEMI) opened its doors in 1994 and now has eight centers in Michigan and a census of over 1,600 participants. By simply implementing internal referral programs, they have seen continued participant growth year after year.

Every PACE program has at least one thing in common – a staff that is passionate about their jobs. So, referral program #1 is targeted toward PACE employees. PACE SEMI rewards their staff with a gift card every time someone they refer enrolls in their program.

On the other hand, referral program #2 is designed for the participants themselves. It’s fondly known as “Mug Club”. Mug Club rewards participants with a special PACE mug every time they refer someone, whether that referral enrolls or not!

“They [participants] strive to get these mugs and it’s really been helpful actually for our growth,” says Amy Katz, Vice President of Strategic Growth at PACE Southeast Michigan. “They live in a lot of senior buildings that they have friends in, and they tell them about it or family or whatnot. We’ve seen that be a really nice addition to our strategies.”

Strategy #2: View challenges as opportunities

COVID was an opportunity that no one wanted. WelbeHealth opened their first program in 2019, and COVID quickly followed in 2020. However, it did not stop WelbeHealth from reaching the new heights regarding enrollment goals.

“COVID made it, not easier by any means, but people didn’t want to go to nursing homes.” Recalls Mindy Wilds, Regional Vice President for Northern California for WelbeHealth. “We had an opportunity to be able to promote like – we can keep you safe, we can keep you in your homes, we can give you wraparound care and you’re not going to have to go into a nursing home. Nursing home level care, without actually being in a nursing home.”

WelbeHealth put a lot of thought into expanding options for their participants. They wanted participants to still receive high quality care, but in the safety and comfort of their own homes. Every participant received a GrandPad to continuously participate in center activities and check in with their medical team. It’s a strategy they continue to implement years after the initial outbreak of COVID.

Strategy #3: Talk about PACE until you’re blue in the face

People don’t usually know about PACE until they are in a situation where they need it – when a parent begins to decline, when an elderly relative needs a higher level of care, when a loved one wants to age in place and not leave the comforts of home.

“It’s up to us, as PACE advocates, to continue to spread that word again every chance that you get, just so people are aware.”

–Mindy Wilds

It’s important to approach the topic of PACE in a way people will understand. There’s a lot to a PACE program; it has many capabilities and benefits. Be conscientious in how you approach the topic and make sure to not supply an information overload.

Senior PACE Consultant at Tabula Rasas HealthCare, Johanna Dickman, advises, “Simplify the message as far as the criteria for eligibility, the process of enrollment, how referrals work, because sometimes once people grasp all that you could do, then they get intimidated by how complicated the process might be or might sound. So, I think the challenge is streamlining those processes and the message, and making sure that people feel comforted that you’re going to guide them through it step by step.”

PACE SEMI sponsors activities, such as pizza parties or art classes, for local senior living communities. These events are great opportunities to create moments of joy for the seniors, while allowing their internal experts to share presentations on PACE or other educational topics. It creates a carefree space for seniors to have a first-hand experience of PACE, at no cost to them.

“We’re definitely doing a lot more education in the community, which people really want. We saw there be an elevated desire to learn more about health conditions, and so we’ve been doing that.” Katz shares.

Strategy #4: Address what’s holding prospects back from enrollment

Even once you have participants that are interested in your program, there can still be obstacles. For example, some participants may have specific diagnoses or have a close relationship with their doctors and are therefore hesitant to start treatments with a new care team. It’s important to truly understand what is motivating that participant and find a way to ease their concerns. In this case, it may be helpful to introduce a prospect to the PACE primary care provider before they enroll or take the time to explain the transition process.

Katz shares, “I’m sure as everyone else experiences, and this may or may not be the case, but once they start in PACE and they really start experiencing it, they don’t go back to their previous primary care physician because it’s just an incredible family that they meet here.”

In many cases, seeing is believing. It could also be helpful for a prospect to have a small “trial run” before they enroll to get a taste of what life will look like. PACE SEMI encourages prospects and their families to come in, have a meal, and experience the activities. If participants aren’t comfortable coming in person, they also offer videos or virtual tours.

“It takes time, and it takes relationship building sometimes to get that person to really trust it’s [PACE] is a good decision for them.

–Johanna Dickman

Strategy #5: Embrace your population’s culture

Know your market. PACE can truly make a difference in participants lives by providing individualized care that honors their culture. This could look like nurses who speak their language, traditional foods or meals from their culture, or amenities that respect their religion, like a prayer room.

“I think that understanding your community where your PACE program is located and making sure that you understand the cultural needs to create your program or structure your program to strengthen or to lean towards those is important,” Dickman advises.

It can be impactful for participants to see how much your PACE center cares about their population. Embrace who they are, learn more about it, and do what you can to help. Don’t be afraid to get creative or find help from within your community. Consider partnering with a dietician or food specialist who caters to their population. Even something that simple could bring familiarity and comfort to a participant that can’t be put into words.

“Knowing your audience and making sure you provide what’s needed for them to be comfortable to come to the center, and for their families to feel good about them coming. It feeling good, like a great place to come, I mean, that’s the whole point here and to help,” says Katz.

Strategy #6: Support your participants AND your internal team

Let’s say all goes well and your enrollment rapidly increases month over month. This is great news, but will a new obstacle appear from this growth?

Participant enrollment is wonderful and it’s a goal we strive for, but don’t forget about your staff. Make sure they are prepared for the amount of intake each month, and don’t be afraid to get creative if the numbers start to feel overwhelming.

“We never want to grow irresponsibly. We want it to be a very responsible growth. We want to make sure that we have things in place to grow because at the end of the day, our compass provides excellent clinical care to our participants. We all know that if you don’t have the team in place, if you don’t have the bodies in place to do that, you’re not going to be able to do that,” shares Wilds.

Both PACE SEMI and WelbeHealth found a great solution for their IDT team. They developed a position within their organization called Participant Advocate or Participant Navigator. This person acts as a liaison between the participant and the IDT and guides the participant every step of the way. They onboard them, educate the IDT on the participant to help develop and manage care, handle communications with the participant and their family, and more. It’s a role that supports the participant and relieves the IDT from certain tasks, so they can just focus on providing excellent care.

“We definitely say to the IDT, if not us, who? It really is impactful because the people we have doing the care feel like, “you’re right! It needs to be us!” They’re amazing. They’re really here because they want to take care of people and they really, really focus on the mission of PACE, keeping them at home.”

–Amy Katz

PACE changes lives every single day. The work we do is impactful and can’t be delivered by any other program. The proof is in our participants – the improvements in their health, their quality of life, their joy. Let’s transform PACE from being the “best kept secret” to the “best thing that’s ever happened”.

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