The state’s first all-inclusive managed care program that helps keep elderly folks independent is in great demand here in Wichita, but current state Medicaid caps are keeping many potential clients at bay.
That may change as early as this summer.
Via Christi HOPE officials say they are hoping the government will lift or increase those Medicaid caps, citing a 10-year track record showing Kansas saves tens of thousands of dollars through HOPE services by keeping clients out of nursing homes – a savings of just under $12,000 a year per person in most cases.
HOPE houses Kansas’ first national Program of All-Inclusive Care for the Elderly, or PACE, funded by a special Medicare-Medicaid rate designed to help lower-income seniors get services they need to stay independent as long as possible.
HOPE can provide in-home meals, transportation for medical appointments and personal care assistance such as help with bathing, housekeeping and health. It also offers transportation to its day center, where residents can socialize, participate in activities or use the medical clinic or exercise equipment.
“We have grown, but we’d like to be bigger," said HOPE chief executive Justin Loewen. “Right now our hands are tied, but we are extremely encouraged by what we’re hearing from (the state) about expanding PACE statewide within the larger Medicaid reform initiative."
PACE serves people 55 or older who are certified by the state to need nursing home care but who are able to live safely on their own at the time they enroll, according to the National PACE Association. Officials point out that although all PACE participants must be certified to need nursing home care to enroll, only about 7 percent of participants nationally reside in a nursing home.
That’s what appealed to Wichita PACE participants David and Dale Wilson, who enrolled in HOPE’s program in December 2010 and who said they have seen their lives dramatically improve through physical therapy and managed medical care.
“Via Christi HOPE saved David’s life – he might not be here with me if it wasn’t for this program," said Dale Wilson, 65, of her 69-year-old husband, whose underlying health issues were diagnosed and treated through the program.
“I was in an electric wheelchair when I joined HOPE. Then I started using a walker, and now I don’t even need my walker."
The nursing home allows PACE participants whose health declines while in the program to transfer seamlessly to long-term care. Via Christi HOPE officials also are ramping up their home technology benefits – monitoring and assisting elderly clients through security devices and emergency response equipment – and see that as a potential growth strategy in the future.
“It really is about getting the right care at the right time in the right place," Loewen said. “We all want to be cared for in our homes when we can, and when we need more care, it should be reasonable and efficient. That’s what HOPE offers through the PACE program."
HOPE went into business in 2002 with five clients. By 2006, it had outgrown its space in the Parklane Shopping Center and moved its adult day care downtown into the old Riverside Hospital building. There, program space was expanded to 36,000 square feet and a 24-bed nursing home was added.
Today, HOPE serves 213 seniors in its PACE program – eight clients more than its Medicaid cap of 205 because some are private payers. Loewen said a good-faith gesture from Medicaid officials may result in a cap increase of 12 to 24 participants by July.
“I think what we’re seeing is the state is showing its commitment to expanding and growing PACE," Loewen said.
Recent studies show that the mortality rate among enrolled PACE participants drops 32 percent, Loewen said. That and the proven savings are keys Via Christi senior services officials hope to leverage to expand the program into rural areas statewide.
To underscore their advocacy for such services, Via Christi HOPE officials supported the formation of the state’s second PACE program in Topeka in 2006, even though it is operated by a different health system.
“Realistically, we know we’re not able to manage all the growth across the entire state, but we know we are very interested in looking at what this could mean for us in terms of expansion and growth," Loewen said.