Overcoming Objections to PACE Begins With Empathy

Includes 9 Reasons Why We Hear Objections

You’re focused on fulfilling the mission of your PACE and bringing PACE to more elders. You're driving enrollment growth and showcasing PACE in the community. Yet you hear the same objections, and wondering, "how do I overcome objections?"

It’s time to rethink that. Instead of “overcoming objections to PACE,” think of objections as strategic insights.

Each objection reveals an insight about:

One person - the candidate, the family caregiver or the referrer
Our relationship with the person -- have we simplified and clarified the benefits PACE for that person's life? Have we built value for PACE?
The PACE's operating strategy -- is it meeting the challenges of today's 10x more competitive market?
IDT's responsibility -- are they accountable for growth, or is that siloed into marketing and outreach?

The insight gives us actionable information to strengthen trust, tailor our message, and help them envision thriving in PACE. Or, it gives us information on operationalizing change in the organization.

Read: Why "I don't want to change my doctor" is the #1 objection heard in PACE

Objections are Not the End of the Conversation

PACE enrollment professionals who don't come from commission sales backgrounds -- I would guess that is 9 in 10 -- often have prior jobs in the caring professional -- healthcare, senior care, hospice of palliative care or social services. And because of their prior training, sometimes objections feel really icky.

These non-salespeople often struggle when a candidate for PACE puts up a roadblock, an objection. Some might accept an objection statement -- "I don't want to ____" -- as the end of the conversation.

An objection should not be the end of enrollment, or the end of today's conversation. We can continue the conversation, to learn more about this person.

And isn't learning about this person the start of person-centered care? Yes!

Objections to PACE are Insights About This Person

Don’t view objections as resistance. View them as natural. They are an invitation to build the relationship, and dig deeper. It’s also our signal that we need to elevate PACE’s value for this particular participant, family caregiver or referrer.

With the right approach, objections become stepping stones, not stop signs.

Engage with empathy.

Reframe the process from handling objections to expecting objections.

We expect objections, we want objections in a way -- because when someone thinks through their objection, we have someone who is self-advocating. They can “see” how PACE works for them, in their mind.

9 Reasons People Raise Objections to PACE

People don't just sign themselves up for PACE because it's all that. Our approach -- in our Empathy Enrollment Method -- is steeped in understanding who you are speaking with, what they are feeling, and truly meeting people where they are in very concrete terms.

Understanding why people have objections helps us build a trusted relationship. Here are 11 reasons objections come up when talking about the Program of All-inclusive Care for the Elderly (PACE):

Expressing adult agency

Many candidates, especially those who are actively managing their own health and finances, see themselves as decision-makers.

An objection to PACE often serves as a test—they want to see if PACE can stand up to scrutiny.

A Smaller Social Network

As people age into their 70's and 80's, their world often becomes smaller—familiar routines, trusted relationships, and comfortable spaces take on heightened importance. Their social circles are smaller -- people have moved on, or moved out. Old friends and family have passed away. People travel in a smaller geographic sphere.

This shrinking world makes trusted connections with doctors, caregivers, and even routine encounters a significant part of a person's stability. When considering a shift to PACE, the idea of changing any of these familiar relationship can feel overwhelming, as it touches on the very sources of security they've carefully built over time.

Recognizing this can help us reassure them that PACE respects and builds upon these familiar foundations, offering comfort in a way that feels safe and manageable.

Investment in the Decision they Made on their Current Healthcare

Many candidates have invested considerable time in finding and building relationships with providers they trust.

For many, switching doctors or health care plans isn’t just about change—it’s about having already invested a lot of time, effort, and emotional energy in finding the right fit. They might have gone through multiple doctors before finding someone they trust and who understands their needs.

Now, asking them to switch again can feel like a step backward. It’s not about fearing change, but rather protecting the hard-earned stability and comfort they’ve finally found in their current situation.

Loss of Economic Power

Enrolling in Medicaid, risking estate recovery, or losing a flex card (spending card) is not merely a financial decision.

Elders derive self-respect, admiration and familial status from economic assets:

•Owning a home, to leave a legacy;

•Creating a job as a caregiver for a family member; or

•Having extra money or buying power to use as they please (for themselves or others).

Hard-Earned Skepticism

People who have lived until their 70th or 80th birthday have seen a lot. They know that they are "worth" something to the organization, even if they are not paying for services. And as dually-eligible individuals, they have heard a lot of promises that have not been fulfilled.

So their skepticism is natural and a badge of honor.

Trust was not built

Trust-building takes time. An objection may simply mean that more groundwork is needed to establish rapport and confidence. Perhaps the conversation was rushed, or there were too many “hand-offs” from one person to another.

Information overload

Navigating healthcare decisions is overwhelming. People may already dealing with multiple health conditions or stressful family dynamics. They may receive confusing, unclear information about all the options from multiple health plans.

It's too Early

The stages of frailty come for many people. At the earliest stages of frailty -- and I mean CLINICAL frailty -- people with health setbacks can rebound. Perhaps they can rebound to 90% of their previous "base level." But every subsequent health episode will have them rebound less and less.

In the earliest stages of frailty, people are simply not ready for PACE. They have "bounced back" and feel ok.

Same for the earliest stages of caregiving for a family member, where optimism abounds and we think, "I got this." It's too early.

This is where your follow-up systems and technology come into play. This person may be ready in 3, 6, or 9 months. Stay with them.

Little Clarity on PACE's Benefit

Some objections arise when participants simply can’t “see” themselves in the program. It’s critical here to paint a vivid picture of what day-to-day life in PACE looks like. Avoid jargon and be specific about the “what happens here,” how people feel, the difference it makes.

It is in learning about the person -- when we are asking discovery questions -- that people see an internal movie play out in their mind. That is how they envision how PACE can bring hope and optimism (and healthy outcomes) into their lives.

What are the Top Objections to PACE?

Our 2023 Generations Now Survey of 104 Professionals in PACE (across disciplines) showed the top concern is "I don't want to change my doctor."

Anecdotal evidence supports the hypothesis that "I don't want to lose my spending card" is growing in frequency as an objection during calendar 2024.

Screenshot of a poll at the National PACE Association conference showing "Don't want to change doctor" as top concern.

When Objections to PACE Become Leadership, Operating and Process Issues

Some objections are lasting and do not go away or resolve without operational changes.

Your PACE enrollment and intake may be doing everything right -- building value, using storytelling, doing thorough discovery -- and the objection is still there.

There are objections that marketing and enrollment can't handle, but leadership can. Generally, these objections to PACE are:

"Don't want to change the doctor" and the center physician or a nurse won't meet with candidates (potential PACE participants).
"Don't want to change the doctor" and there are no "visits to your old doctor."
"Don't want to change the doctor" and a trusted specialist isn't in your network --> see #1.
Your PACE isn't offering a spending card.

Start on the road to a solution by gathering data:

Outreach and enrollment and intake must gather data on objections raised and objections resolved. Either in a spreadsheet, or shared in weekly meetings.
The Director of Marketing must have data to show that these "real objections" are arising, and discuss with leadership the cost-benefit of operationalizing solutions.
If you can show 10 enrollments you did *not* get -- 10 names people PACE is not serving -- because flex spending or grocery cards are not part of the care plan, that is real data.

How to be Ready for Objections

Every objection is an invitation to strengthen our approach, deepen our connection, and reinforce the life-enhancing impact of PACE.

Enrollment is the start of person-centered care. So use objections as a door to understanding.

Read about the results PACE organizations achieve by creating an empathy-driven enrollment process in partnership with Generations Now.

We provide customized training programs to differentiate your PACE, accept and work with the objections unique to you, and have outreach and enrollment conversations that convert. Get in touch to learn more.

How to "Handle" Objections

Now that we are "accepting" -- even welcoming objections, what do we do next?

Here are 3 frameworks for handling objections in PACE:

1. Storytelling Framework

Your team leader will harness the power of their group to gather testimonials that are "objection testimonials." These are testimonials from participants, family caregivers and referral partners. In each testimonial, instead of PACE is the hero ("and then they discovered PACE), you make the participant the hero. When the participant is the hero, they make the heroic decision to overcome an objection, and their journey completes in meeting a goal or positive health outcome.

2. Feel Felt Found + Curiosity

This is mentioned in the video above. You acknowledge their concern but aligning with how they "feel." You ease that concern by sharing that others have "felt" the same way. You share a benefit by saying what these other people have "found" once they are in PACE. But you can't stop there, otherwise people will feel "bulldozed." Keep going and ask follow-on questions -- get curious about their objection -- get deeper and find out what is behind it.

3. Table and Come Back with Firepower

This is when the objection is "too soon." For example, when someone is worried about changing their doctor and it is early in your process, you can table the objection. "Let's come back to that, we aren't sure yet if you even qualify medically." Then, you come back to it by addressing it -- with more firepower. You might bring in a nurse, or a doctor to meet them, to build that relationship. Or, you bring the firepower by building more value for PACE.

Create Objections Tools

The tools you want to give your team -- and we can facilitate and co-create these with you -- are stories, scripts for practice, role-playing for confidence, and documenting your approach. Then build coaching into your workflow, to keep the team on-point, iterate improvements, and reveal and resolve new challenges.

Schedule Time for a Meet and Greet by Phone or Zoom

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