Dana B. Mukamel, Ph D¹, Derick Peterson, PhD², Rachel Ritz, MS³, Stephen Kunitz, MD, PhD⁴, T. Franklin Williams, MD⁵, Alina Bajorska, MS⁶, Diane Gross, PhD⁴, and Helena Temkin-Greener, PhD⁶. (1) Department of Medicine, Division of General Internal Medicine & Primary Care, University of California, Irvine, Health Policy Research, 100 Theory, Suite 110, Irvine, CA 92697, 949 824 8873, dmukamel@uci.edu, (2) Department of Biostatistics, University of Rochester, 601 Elmwood Avenue, Box 630, Rochester, NY 14642, (3) Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Avenue, Box 644, Rochester, NY 14642, (4) Department of Community and Preventive Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 644, Rochester, NY 14642, (5) Monroe Community Hospital, 435 East Henrietta Road, Rochester, NY 14620, (6) Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 644, Rochester, NY 14642

The PACE program is a unique model of care for nursing home certifiable individuals who wish to remain in the community. It is the only program in the country which is capitated for both acute and long term care (Medicare and Medicaid) and it has a unique approach to care, relying on day care, home care and a multidisciplinary care team. Despite the common philosophy, financial incentives, and type of patients that PACE programs have, they exhibit substantial and statistically significant variation in participant health outcomes (measured in terms of risk-adjusted mortality, decline in functional status and self assessed health). This study investigates the effect of 8 types of program characteristics to identify those that are associated with superior health results. These include program age, size, case mix, practice style, staffing patterns (numbers and salaried vs. contract workers), financial health and organizational structure of the program and its market environment. We use DataPace in conjunction with data from interviews of program directors and financial officers, team survey and census data in estimating statistical regression models to test hypotheses about the associations between program variables and outcomes. We find that mortality outcomes are significantly associated only with variables describing program case mix and practice styles. Functional decline on the other hand is associated with all program characteristics except for its market environment and whether or not aides are salaried or on contract. The results provide insights into the inner-workings of programs such as PACE.

Learning Objectives:

• At the end of the presentation participants will
• 1) Understand the unique features of PACE
• 2) Know which program characteristics are associated with better health outcomes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.