vida: extract from 2025-03-17-norc-pace-market-assessment-for-profit-expansion.md

- Source: inbox/archive/2025-03-17-norc-pace-market-assessment-for-profit-expansion.md
- Domain: health
- Extracted by: headless extraction cron (worker 6)

Pentagon-Agent: Vida <HEADLESS>

inbox/archive/2025-03-17-norc-pace-market-assessment-for-profit-expansion.md

@@ -7,9 +7,14 @@ date: 2025-03-17
 domain: health
 secondary_domains: []
 format: report
-status: unprocessed
+status: null-result
 priority: high
 tags: [pace, all-inclusive-care, elderly, capitated-care, scaling-barriers, for-profit, integrated-care]
+processed_by: vida
+processed_date: 2026-03-11
+enrichments_applied: ["the healthcare attractor state is a prevention-first system where aligned payment continuous monitoring and AI-augmented care delivery create a flywheel that profits from health rather than sickness.md", "value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk.md", "pace-demonstrates-integrated-care-averts-institutionalization-through-community-based-delivery-not-cost-reduction.md"]
+extraction_model: "anthropic/claude-sonnet-4.5"
+extraction_notes: "Three claims extracted focusing on PACE as existence proof of attractor state model (works but doesn't scale), for-profit entry as potential inflection point, and proven viability at individual program level. Three enrichments: challenge to attractor state convergence assumption, extension of payment boundary analysis to 100% risk case, confirmation of community-based care value with 2025 growth data. The 0.13% penetration after 50 years vs MA's 54% is the key tension—model elegance vs market reality."
 ---
 
 ## Content
@@ -69,3 +74,14 @@ tags: [pace, all-inclusive-care, elderly, capitated-care, scaling-barriers, for-
 PRIMARY CONNECTION: [[the healthcare attractor state is a prevention-first system where aligned payment continuous monitoring and AI-augmented care delivery create a flywheel that profits from health rather than sickness]]
 WHY ARCHIVED: PACE is the strongest counter-evidence and supporting evidence simultaneously — it proves the model works AND that structural barriers prevent scaling. Essential for honest distance measurement.
 EXTRACTION HINT: The 0.13% penetration after 50 years is the key number. Compare to MA's 54% — what does the gap reveal about what actually scales in US healthcare?
+
+
+## Key Facts
+- PACE enrollment: 80,815 (Jan 1, 2025) → 90,580 (Dec 31, 2025) = 12% annual growth
+- 198 PACE programs operating in 33 states + DC as of 2025
+- 376+ PACE centers serving ~87,000 participants (September 2025)
+- Nearly 50% of enrollees served by 10 largest parent organizations
+- Over 50% of enrollees concentrated in 3 states: California, New York, Pennsylvania
+- Only 13 states have 1,000+ PACE enrollees
+- Average PACE member: 76 years old, 7+ chronic conditions, nursing-home-eligible
+- PACE model originated in 1970s with On Lok pilot in San Francisco