SCAN Health Plan, Commonwealth Care Alliance Back New PACE Model

The Program of All-Inclusive Care for the Elderly (PACE) model has certainly drawn increased interest during the COVID-19 pandemic, a frequently repeated fact that’s both generally true and also relatively ambiguous.

Now, there are organizations and faces behind that “interest” in the home- and community-based care model.

At the end of February, SCAN Health Plan and Commonwealth Care Alliance (CCA) announced that they were teaming up to help form a PACE organization dubbed myPlace Health. The venture, originally formed last September, will be run by founder and CEO Robbie Pottharst.


SCAN Health Plan is part of the larger SCAN Group, a company that invests in new ventures that support healthier aging. SCAN Health Plan is a nonprofit Medicare Advantage plan that serves 270,000 members in California.

On its end, the Boston-based CCA is a multi-state nonprofit integrated care system. The organization helps “advocate for affordable, high-quality and cost-effective policies that lead to health care equity for individuals who need it most.” It currently operates in Massachusetts, Rhode Island, California and Michigan, serving more than 62,000 individuals.

myPlace Health will initially serve seniors in the markets that both SCAN Health and CCA operate in.


“They’re two nonprofit organizations with leaders that care about their missions. PACE fits squarely within those [buckets],” Pottharst told Home Health Care News. “This was a very logical option for them to expand their portfolio and reach. … And for me, I now get to focus on this issue, which I care deeply about.”

Pottharst is a health care veteran, having previously worked for organizations such as CareMore Health, Kaiser Permanente and CityBlock Health.

He’s also had personal experiences with loved ones that further opened his eyes to the fact that “there weren’t care models appropriately designed, incentivized or built to support senior needs.”

myPlace Health will be run independently, but the support of its two strategic partners will make its runway to success easier, Pottharst added.

“PACE requires intense focus and capabilities, and we’re building this model on its own,” he said. “That said, we now have the wealth of experience from SCAN and CCA to build upon. And they bring an incredible track record in serving frail older adults and dual eligibles.”

Broadly, the PACE model is an alternative to the nursing home for dual-eligible patients. There are over 2 million seniors in the U.S. that qualify for the program, yet only about 3% utilize it – either because they don’t know it exists or because there’s an access issue.

ConcertoCare, a value-based care provider that offers an array of home-based care services, announced in February that it had raised $105 million in a Series B and was launching a PACE with part of the funds.

Policy momentum and private equity interest have also created tailwinds for PACE of late, as a model that is more based on value and “merits investment.”

“COVID certainly accelerated things, but the broader opportunity is that there are hundreds of thousands of Americans that needlessly crash into expensive nursing home care every year when they should not need to,” Pottharst said. “There should be models that enable our seniors to age in place – to remain at home, in their communities, with their loved ones – period. Full stop.”

The pandemic highlighted the success of PACE because it has what Pottharst calls a “capitated care backbone.”

“Capitation equals freedom,” Pottharst said. “Value-based capitated models give clinical organizations the freedom to reorganize care in whatever manner is best for each specific patient.”

As for SCAN, it will be able to better keep its beneficiaries out of nursing homes with its own strategic investment in PACE.

Over time, each involved organization hopes that myPlace Health can be scaled, but also that the PACE model can be scaled more overall.

“SCAN is proud to partner with CCA, an organization that shares our commitment to improving care for older adults, as we develop this new organization,” Dr. Sachin Jain, president and CEO of SCAN Group and SCAN Health Plan, said in a statement. “Through this unique partnership, myPlace Health is perfectly positioned to directly advance SCAN’s mission to keep seniors healthy and independent.”

Pottharst believes there are three main ways to increase access to PACE for Americans.

For starters, allowing greater access to the model through more programs and legislative efforts across the country will certainly help.

On top of that, conducting community outreach and marketing the program to those that are eligible will help boost awareness.

Lastly, finding the right partners is essential to PACE growth. Those partners include home health and home care providers, with PACE operators engaging with them to create comprehensive offerings.

“There are some excellent examples of partnerships with … community-based and home-based care organizations that could yield tremendous results,” Pottharst said. “It’s about finding those partners that can maximize what’s available in each market.”

Companies featured in this article: