Palliative care is integral to Programs for All-Inclusive Care of the Elderly (PACE) programs, according to Dr. Glenn Meyers, who was recently promoted to chief medical officer of BoldAge PACE.
New Jersey-headquartered BoldAge emerged last year, established by a group of former hospice and home health leaders. The company currently operates four PACE centers located in the Northwest and the Midwest, with two more slated to open before the end of the year. Ultimately, BoldAge PACE plans to build a national footprint.
Meyers has practiced medicine for more than 40 years. His specialties include internal medicine, cardiology, bariatric medicine and health care administration, with additional expertise in value-based care. He joined BoldAge in July 2023.
Palliative Care News sat down with Meyers to talk about the company’s growth plans and where palliative care fits into their service model.
What are your top priorities as you step in as CMO?
My main priorities as CMO are empowerment and education. So this means empowering individual medical directors in each of our centers so that they know how to be medical directors, to be able to teach the providers and oversee the providers. In leadership, they need to not manage and tell them what to do, but support them in everything they do, teach them how to synthesize a proper care plan and follow that care plan.
I’m going to quote my dad, who was a physician. He said, “If you treat people head to head, they’re not going to get better. But if you treat them heart to heart, that will cure them, because if the patient doesn’t like you, they won’t get better.” And that’s what I wanted to get into every PACE provider. That empathy is already in every pace employee that I’ve met in all of our centers so far, just like in hospice.
What are some of the key skill sets that an effective medical director should have? What does a really good medical director look like?
A really good medical director empowers his providers. We try to hire providers with geriatrics experience, at least several years worth, because our participants are much sicker than the average. So we want people with experience, but we also don’t just want consultologists.
Our whole goal is to keep participants happy and healthy in the community. So the medical director, he or she needs to be able to look at each and every consult before they go out to make sure that it’s not something we can do in-house. I want them to see everyone that they need, not one more and not one less.
Can you say a little bit about where palliative care fits into your care model?
I love palliative care, and PACE is essentially palliative care. We collaborate with palliative care organizations when needed, but we have participants who are sicker than most.
If we don’t catch their diseases and help them not just stabilize but get better, they’re going to end up going in the wrong direction. So we are palliative care, and palliative care is not just the next step before hospice. It’s taking care of people in a very concentrated manner, in a good manner. So that’s where we are. We collaborate with other palliative care organizations when needed, but that’s what we do. It’s not all that we do, but it is a lot of what we do.
In what circumstances might you collaborate with a separate palliative care provider?
Sometimes we may not have enough providers to go out to their home, to help them. It may not be geographically desirable, because they may be out at that outer limit. We try not to go outside of half an hour. So when we don’t have enough services for a particular individual, that’s when I think we would use them.
We’ll do that for any specialist, not just palliative care. If we can’t do it in-house, we want to use somebody else. We contract with palliative care wherever we are before we start.
BoldAge has pledged to expand its locations from four to 10 by 2026. Where does the medical staff fit into achieving that kind of growth?
We started out with the two centers, which are under one contract. We’ll have five this year. Next year, there’s a potential for a lot more than that; 10 is probably the low end of where we’ll be.
So where’s the medical staff? I step in personally when we’re looking at the plans to make sure that we have the right exam rooms in the right place. One of the things I added to the plans is we need to have a special station to do their vital signs. It just makes it so much easier to get everything done and on the computer in an efficient manner.
Then where I step in clinically, or where the clinical team steps in is when we hire a medical director first, wherever possible, and I train them, and he trains and picks his own new providers. There’s a director of clinical services that’s a nurse or a nurse practitioner who picks the nurses. We’re all on the calls and interviewing all of them, because we’re an interdisciplinary team.
Are BoldAge physicians full-time employees or are they contractors?
They are full-time employees.
And as you work to achieve these goals, what do you see as the biggest challenges or obstacles?
The biggest challenge or obstacle is always education — finding people who are willing to empower those that are actually in the exam rooms, and then growing what I like to call memorializing our processes so that we don’t have to do it the same everywhere. We have to have basic groundwork, but we’re not setting up rules and regulations. We want people to know what’s worked best in the past.
