Five Questions With: Joan Kwiatkowski

JOAN KWIATKOWSKI is chief executive officer of CareLink Inc. and Pace-RI. / COURTESY PACE-RI
JOAN KWIATKOWSKI is chief executive officer of CareLink Inc. and Pace-RI. / COURTESY PACE-RI

Joan Kwiatkowski is chief executive officer of CareLink Inc., a nonprofit health management services organization, and of PACE-RI, the state’s only nonprofit health plan that serves frail elderly individuals who wish to age in place but need assistance to do so. PACE-RI is one of several dozen such programs around the country.

A former faculty member of Boston University’s School of Social Work and a former adjunct professor at Tufts Medical School, Kwiatkowski earned her undergraduate degree in psychology from Boston College and her master’s degree in social work from Boston University. She also completed a certificate in advanced graduate studies in nonprofit administration at the Stanford School of Business.

Kwiatkowski talked with Providence Business News about PACE-RI, the services and programs it provides to its clients and its decision to spin off from CareLink Inc.

PBN: Tell us about PACE-RI and its clients; what services does it provide, how many employees and where does it operate?

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KWIATKOWSKI: PACE-RI is the only nonprofit PACE health plan in the state. It is a unique, provider-based Medicare/Medicaid health plan created specifically for adults 55 and older who are chronically ill and at risk of needing a nursing home. We are one of 116 fully capitated (flat reimbursement fee) PACE programs nationally that serve the frail elderly in our community.

The majority of PACE-RI participants are eligible for both Medicare and Medicaid. Our participants have multiple chronic diseases such as kidney disease, depression, diabetes and heart failure; they also need assistance with many activities of daily living, such as eating, walking and dressing.
We currently have 277 enrolled participants and 105 employees who work at our three medical centers located in Providence, Westerly and Woonsocket.

PBN: What was the motivation to spin off from PACE-RI’s parent organization, CareLink, and why now?

KWIATKOWSKI: CareLink had the vision to bring the PACE model to Rhode Island in 2005. Right from the beginning, it was our goal for PACE-RI to become an independent, financially stable, freestanding nonprofit entity. As a risk-based model of care, PACE-RI manages high, and often unpredictable, medical costs related to the care of frail older adults, so it took some time to get established. Now was the right time, with 11 years of experience as a mature and financially stable program, for PACE-RI to launch as an independent entity.

PBN: What is CareLink and why did CareLink bring the PACE model to Rhode Island?

KWIATKOWSKI: CareLink is a national model of successful collaboration. Our members are independent, long-term care service and support organizations that create programs and quality improvements to benefit the seniors that we serve. This year, 2017, marks our 20th anniversary; our mobile dentistry program, called “Wisdom Tooth,” and PACE-RI are two shining examples of successful initiatives that have been borne out of this collaborative network of geriatric care providers.

PBN: What makes PACE-RI different from other Medicare/Medicaid managed care plans?

KWIATKOWSKI: What makes PACE-RI different from health insurers is our ability to bring together a coordinated team of doctors, nurses, social workers and therapists to create an individualized care plan to address the specific medical and social needs of each older adult who participates. We design the plan, implement it as a team and can adapt it responsively, as needed, because we’re right there, observing and interacting with participants on a regular basis.

While participants receive most of their care directly through PACE-RI’s employed health care professionals in our day centers, we also have a provider network, which allows us to contract with specialists, hospitals, nursing homes, home care agencies and others to ensure participants receive all the services they need to stay healthy and as independent as possible – 24 hours a day, seven days a week, 365 days a year.

PACE-RI is primarily funded through Medicare and Medicaid. We are paid a flat, capitated payment for each of our participants who are eligible for these programs. Our progressive reimbursement system is also frequently cited as an exemplary model by policymakers working to redesign health care payments based on cost and efficacy.

PBN: Does a strategic plan guide your work and, if so, what are the main priorities for PACE-RI in 2017?

KWIATKOWSKI: PACE-RI is well-prepared for the future. We are a fiscally smart health care model, unafraid of change and eager to lead innovation. We are ready to face the new opportunities, challenges, financial scrutiny and new mandates that the federal government will undoubtedly unveil for health care providers.

In 2017, our focus will be on four strategic priorities: participant and family-engagement, training and education of physicians and other health care professionals, business innovation in new markets, and clinical and financial performance.

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