“A Different Way of Looking at How You Can Age in America”

Amid debate in Washington, DC, over the future of Medicare and Medicaid, a nonprofit that develops better ways to care for seniors has taken full ownership of an entity built around one of CMS’ oldest care models.

Earlier this month, SCAN Group announced it had assumed full leadership of myPlace Health, an organization that SCAN launched in 2021 with the Commonwealth Care Alliance (CCA). myPlace Health was created to bring PACE, the Program for All-Inclusive Care for the Elderly, to Los Angeles, more than 50 years after the originator of this model opened its doors in San Francisco.

SCAN Group CEO Sachin H. Jain, MD, MBA, FACP, explained in an interview that his nonprofit group acquired CCA’s equity in myPlace Health as it makes plans to add a second PACE site in Compton, California.

The move is something SCAN pondered for years, Jain said.

“Our mission when we were founded in 1977 was to keep seniors healthy and independent,” he said. “Over the course of its history, SCAN had contemplated entering the PACE space, because there are few models that are more oriented toward the health and independence of older adults.”

A key to SCAN’s growth has been working with like-minded partners and companies, and myPlace Health, under CEO Robbie Pottharst, offered such an opportunity. “Robbie has built a world class team of people who know PACE really, really well,” Jain said.

With seniors accounting for a larger share of the US population, experts warn that with more seniors living alone, caregiving gaps will grow.¹

PACE is positioned to meet these challenges, Pottharst said. “You’ve got the silver tsunami of baby boomers, but then the increasing population of folks who literally can't afford care,” he said. “So, you have both the naturally growing population and then the greater proportion of folks who will be funded by Medicaid sponsored care. You put those two together, and we need PACE on every corner.”

How PACE Can Meet Needs of Vulnerable Seniors

PACE serves adults aged 55 and older who qualify for nursing home care but would prefer to stay in their own homes and communities. Participants receive comprehensive services that include an integrated health plan, primary and behavioral health care, transportation, and a social outlet. Nearly all of the country’s 83,000 PACE participants are eligible for both Medicare and Medicaid, which provide a capitated payment for each enrollee to the PACE entity; those receiving Medicaid have no out-of-pocket costs.²

The model grew out of On Lok Senior Health Services, which opened in 1973 in San Francisco’s Chinatown area to provide an alternative for meeting long-term needs of older adults with serious health problems.² On Lok began receiving Medicaid reimbursement a year later, and by the end of the decade had an HHS grant to develop a consolidated care model. Federal legislation in 1997 formally created PACE, paving the way for waivers for the first 10 PACE programs to operate. Today, PACE operates in 33 states, with 106 centers in California.³

Besides keeping seniors out of nursing homes, PACE has been shown to reduce hospitalizations and readmissions as well as rates of depression.⁴ With the number of people over age 65 projected to rise from 58 million in 2022 to 82 million by 2050, the hunt is on for better care delivery models that can slow the rate of spending in Medicare.¹

A recent study charted PACE’s impact with a qualitative study of seniors in Wyoming who lost access to the program due to state budget cuts in 2021. Researchers reported that 3 themes emerged from their interviews: Those who had lost access to PACE were “depressed, anxious, and lonely"; had “no transportation anywhere"; and compared the loss of social contact to “chopping off a part of life.” One woman said she no longer had access to regular worship services. “Now, I do not have a ride to church. Not everybody can handle an old person with a walker,” she told investigators.⁵

Jain noted that the new administrator for CMS, Mehmet Oz, MD, MBA, has given PACE high marks. Days before SCAN Group’s announcement, Oz visited the original On Lok site, where he described PACE as “a different way of looking at how you can age in America."⁶

Oz cited PACE’s focus on seniors’ autonomy, saying, "Instead of being in a nursing home and putting you in a place where you might not want to be, they take you into a community that's all-inclusive."⁶

Jain said the enthusiasm for PACE exceeds what he has seen from prior administrations. “This model has been around for a long time, and because the PACE model has historically only affected a small number of people, it doesn't really get the attention that it deserves.”

“These are the folks who cost the system the most money, and if we can actually provide them with intensive outpatient chronic disease management, primary care, and social support, there's a belief that they're going to cost the overall system less money. And I think for that reason, this is why the Trump administration and Dr Oz have been as positive as they have been about PACE.”

How PACE Fits Into SCAN Group’s Growth Plans

The addition of myPlace Health to SCAN Group comes at a busy time for the nonprofit, which now operates the SCAN Health Plan in 5 states. Besides California, SCAN Health Plan enrolls Medicare beneficiaries in Arizona, New Mexico, Texas, and Nevada, where it recently opened a “storefront” in Henderson.

Nearly 5 years since Jain joined SCAN Group, SCAN Health plan now serves 300,000 Medicare Advantage and dual-eligible enrollees, up from 215,000 in June 2020.⁷ SCAN companies include Welcome Health, which offers primary care, and Independence at Home, which provides referrals for seniors and caregivers. Its investment strategy focuses on like-minded businesses that emphasize seniors’ independence, including Monogram Health, which offers at-home solutions for those with end-stage renal disease, and SafeRide, which provides transportation for medical appointments.

“In the markets where we have overlap, we want to create greater alignment between SCAN Health Plan and myPlace Health,” he said.

With support from Oz, Jain sees opportunities for expansion over time. “We are anticipating that the next several years may be a period of unprecedented growth for PACE,” Jain said. He didn’t rule out bringing PACE to other states, although there are no immediate plans.

An going challenge to PACE expansion nationwide is the need for upfront capital investment in care sites and staff. A rule change in 2016 now allows for-profit entities to take part, and a recent study found these programs account for a growing share of PACE. However, the authors warned that increased for-profit participation would demand more oversight to ensure quality.⁸

As a nonprofit, SCAN Group has posted rising revenues, growing from $3.4 billion to $5.5 billion during Jain’s tenure, which bodes well for myHealth’s growth beyond what Pottharst called its “incubation” phase.⁷

“Our orientation is clinical excellence, quality, and an efficient and scaled operating platform,” he said. “There is no ulterior motive to go public or sell. We want to do something that sets us apart and leads the way for other PACE programs.”

PACE’s growth over time has been slow, but that could change, Pottharst said. “We would all hope to reach more communities and seniors in need. That’s the charge—to really redefine the way PACE can operate, to serve as the model for government-sponsored, value-based care for vulnerable populations.”

References

1. Mather M, Scommegna P. Fact sheet: aging in the United States. PRB. January 9, 2024. Accessed May 21, 2025. https://www.prb.org/resources/fact-sheet-aging-in-the-united-states/
2. An innovative care program for seniors. National Pace Association. Accessed May 21, 2025. https://www.npaonline.org/
3. Winegarden W. The private sector is setting the PACE for managed care. Forbes. April 7, 2025. Accessed May 21, 2025. https://www.forbes.com/sites/waynewinegarden/2025/04/07/the-private-sector-is-setting-the-pace-for-managed-care/
4. Segelman M, Szydlowski J, Kinosian B, et al. Hospitalizations in the Program of All-Inclusive Care for the Elderly. J Am Geriatric Soc. 2014;62(2):320-324. doi:10.1111/jgs.12637
5. Dabrowski BS, McKibbin CL, O’Barr GW, et al. The closure of Wyoming’s Program of All-Inclusive Care for the Elderly (PACE): qualitative analysis of the impact on social isolation and loneliness. Front Public Health. 2024:12:1426100. doi:10.3389/fpubh.2024.1426100
6. New CMS administrator Mehmet Oz visits On Lok in San Francisco. National Pace Association. May 9, 2025. Accessed May 21, 2025. https://www.npaonline.org/about-npa/news/news/2025/05/09/new-cms-administrator-mehmet-oz-visits-on-lok
7. Now 300,000 Members Strong: SCAN reaches membership milestone amid rapid growth and diversification. News release. SCAN Group; March 20, 2025. Accessed May 21, 2025. https://www.scanhealthplan.com/about-scan/press-room/march-2025/300000-members-strong
8. Miller KEM, Gupta R, Polsky D. Growth of the Program of All-Inclusive Care for the Elderly and the role of for-profit programs. Health Aff Sch. 2025;3(1):qxae174. doi:10.1093/haschl/qxae174.