Health

14 HEALTH • Spring 2016 As senior population swells, insurers get proactive \\ By Susan Shalhoub E conomically, at least, a lot of the focus has been on Millennials as the age group to consider in regard to marketing trends, an alternate work ethic and shop- ping habits, but another population is grow- ing at a pace to exceed the number of Millennials: seniors. The U.S. Census Bureau estimates that those 65 and older will make up 25 percent of Massachusetts residents by 2030 – just 14 short years away. Knowing medical costs will grow right along with the number of elders, healthcare organizations are rallying by keeping more nursing-home-eligible seniors in their own homes with more integrated supports and streamlined resources, which – happily – coincides with seniors' wishes to stay in their homes. STEMMING THE COSTS OF ELDER CARE Many health insurers in or serving elders in Central Massachusetts are putting innovative pre- vention programs in place, such as the PACE pro- gram offered by Worcester-based Fallon Health. A healthy PACE PACE, or Program of All-Inclusive Care for the Elderly, is administered by MassHealth and Medicare (MassHealth). Its goal is to keep seniors living on their own by giving them the tools and supports they need to stay safe and healthy. A 2014 MassHealth study showed PACE partici- pation slowed nursing-home entry by an average 20 months. Among local providers, Fallon was out in front early serving seniors with its Senior ElderCare PACE program, which celebrated its 20th anniver- sary in 1995. "In 1995, very few states had PACE programs," said Richard Burke, Fallon president and CEO. "As it pertains to Massachusetts … In the mid-1990s, Fallon was the only [organization to have it] outside of Greater Boston." In 2004, Fallon was asked to help lead program diversification efforts, expanded, and now operates seven sites (two in Worcester and one each in Charlton, Leominster, Springfield, Lowell and Buffalo, N.Y.) serving 1,000 enrollees, Burke said, the largest PACE program in New England. Based on income, some PACE members pay a monthly premium. For those who are eligible, it's covered by Medicare and Medicaid (known as MassHealth). Services are also available on a pri- vate-pay basis. With a typical nursing home priced at $10,000 a month, Burke said PACE is less expensive and streamlined. "It's state and federal in one package, and we man- age from within," he said. "We become their insur- ance. We take on the risk." Fallon Health's Senior ElderCare PACE program offers social ac tivities like Bingo! in addition to fitness and exercise. Here, par ticipant Ella Fallon hits Bingo! P H O T O / E D D C O T E

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