InnovAge (Nasdaq: INNV) is the largest provider of the Program of All-Inclusive Care for the Elderly (PACE) model in the U.S., based on number of seniors served.
And as more seniors desire to age in place, PACE has become a more popular option, too, with states looking to expand the program and federal lawmakers vying for its usage.
Still, only 3% of PACE eligibles — typically seniors dually eligible for Medicare and Medicaid — participate in the program. A former nonprofit turned for-profit, InnovAge’s goal is to not only expand the PACE market, but also to get more potential participants involved.
With 18 PACE centers across five states and joint ventures with both a health system and senior living provider in California, InnovAge is hoping to capitalize off industry trends to become even more dominant in that market.
In this Changemakers interview HHCN caught up with InnovAge’s president and CEO, Maureen Hewitt, to learn how the company plans to do that — and why that mission is so important. Highlights from the conversation are below, edited for length and clarity.
HHCN: You’ve led through a lot of change at InnovAge. What are some of the changes you’re most proud of?
Hewitt: What I’m most proud of, first and foremost, is the team we’ve built at InnovAge.
And I think it’s just been our commitment to expanding this wonderful program to more frail seniors. I’ve been really inspired by our staff — through COVID — just the way they’ve been so committed to ensuring that frail seniors have been supported during this time.
I would also note just how important it’s been to really take care of each other during a pandemic, and our teams have done an excellent job of that. Our front-line staff, I can’t say enough about them. They have inspired me to just keep doing what we do and keep on with our mission of serving seniors.
The PACE penetration rate is still not great. There’s a lot of room for opportunity and growth for you guys. How has it changed, though, since you have been involved? What was it like 10 years ago?
PACE was really ahead of its time in many ways. I would compare it to the first electric car. It’s 100% globally capitated, at-risk, for only the frail nursing home population.
And I think today, what we’re starting to see, is certainly not just the emphasis on making sure that all Americans get health care, but let’s get Americans into the right program.
When you think about frail seniors, there’s just so much additional awareness that is so needed going forward. There are approximately 2.2 million PACE eligibles across the United States, but it’s continuing to grow. And I think we’ve been at the forefront of really pushing that awareness forward.
What is one initiative or goal that you tried to execute, but failed at that since you’ve been in your role?
I would refer back again to those 2.2 million PACE eligibles across the country that could have access to the program. I want to be able to expand more rapidly to meet this need in our country.
But PACE is a complex program, and it’s highly regulated. And expansion takes a little bit of time. So, you know, I think over the past several years, we’ve refined our ability to build on that ability to be successful and to scale our operations. And we’re continuing to reach more seniors. But I just want to be able to do more, and I want to be able to continue to expand quicker as we look at enrollment into the PACE program.
It seems like you’re a person that generally runs toward change, as opposed to away from it. Do you think that, as an organization, gives you an advantage over your industry peers?
I definitely embrace change. And I also believe that, whether it’s an individual or an organization, it’s important to change and to be able to transform when you have such a great product like a PACE program.
And I think if you’re constantly trying to improve, to do better and be more consistent in your care delivery, you’re going to embrace change. I think we’ve demonstrated that. We converted our company from a nonprofit to a for profit. And recently, we took the company public.
We also have plans to open up shop in Kentucky and launch two centers in Florida — one in Tampa and one in Orlando. We’re continuing to grow. It just requires a lot of strategic thinking and being thoughtful, embracing what we need to do in order to do the right thing for frail seniors.
What has going public enabled you to do as an organization?
We just became public, so I would say we’re at the start of our journey. And one thing about being part of the public landscape is that it allows us to create awareness around PACE. And I think now being part of the public, I’m seeing that there is an acknowledgement of just how important it is to have programs like this. It’s even more important during a pandemic.
If you could change one thing about how health care was delivered in the U.S., what would that be?
I think it’s really about identifying what the consumer wants and needs. What PACE does is bring together that interdisciplinary plan that is customized to the individual — that is key to serving people and doing it effectively and efficiently.
If I were to snap my fingers, I would increase this visibility to PACE programs, not just with InnovAge, but nationally.
What is one positive lasting change that you think COVID has brought on?
I think what it’s done is totally reinforced the importance of human connection and spending quality time with people. I think everyone appreciates that. I think those of us that work in PACE, home care and other forms of long-term care, we recognize the social and health benefits of aging in place — letting seniors live their life, in their homes, in their communities, on their terms.
What’s the breakdown of how much you want to gain in terms of market share?
We think by fiscal year 2023, we’re going to have five new centers, and we’re going to be in more states. And it’s really been, just so you know, a passion and vision of ours as an organization to see this program scale.
I think our scale is going to be significant. We are the largest of the PACE providers based on the number of patients served today. And you’re just going to continue to see us grow.
Historically, it’s an approach of building de novos, organic growth, acquisitions and seeking potential joint venture partners. That’s worked very well for this organization. And we’re going to continue to do that.
What is the biggest barrier to growth for InnovAge
I think the biggest barrier to entry for PACE programs is the cash required to build a new center. It’s prohibitive to many of the nonprofit PACE providers, as it takes $10 million to 20 million to build each center.
Centers need to be fully operational before we are allowed to enroll our first participant. Also, as a fully capitated program, PACE requires us to be fiscally sound and to ensure that we can meet our financial obligations. This requires that we be methodical in our growth strategy.