diff --git a/inbox/archive/2025-03-17-norc-pace-market-assessment-for-profit-expansion.md b/inbox/archive/2025-03-17-norc-pace-market-assessment-for-profit-expansion.md index c4f44458a..ce5f3061a 100644 --- a/inbox/archive/2025-03-17-norc-pace-market-assessment-for-profit-expansion.md +++ b/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