Is PACE Right For Your Organization?
PACE provides clear opportunities:
Proven value-based model
PACE is the gold standard for value-based care models. It is a comprehensive, coordinated, and fully capitated payment program that provides medical and social services to elderly participants who are dually eligible for Medicare and Medicaid benefits.
A large addressable market
There is a large untapped market for PACE. There are an estimated 2.2 million PACE-eligible people in the US—but only 55,000 are PACE participants. The total addressable market for PACE is valued at ~$200 billion.
PACE acts as health insurer for all participants and includes Medicare Part D coverage. It utilizes lower-cost preventive care to avoid higher-cost hospital and nursing home care settings.
Begin your organization’s PACE journey
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What is PACE?
The PACE (Program of All-Inclusive Care for the Elderly) concept began in 1973 in San Francisco, California, with the mission of serving seniors with long-term care needs in their community rather than in institutional settings. Since then, PACE has grown from a demonstration project to a permanent Medicare- and Medicaid-funded state-optional program serving over 55,000 participants in 31 states.
Qualifying for PACE
To qualify, participants must be age 55 or older, live in specified service areas, meet nursing home eligibility per state requirements, and live safely in the community with help from PACE. According to the National PACE Association (NPA), 95% of PACE participants continue to live in the community.* The model’s success is attributed to:
- The participants’ access to the entire continuum of healthcare services
- Alignment between providers’ financial incentive and participants’ quality of life
- Opportunity to combine funding streams
*National PACE Association. Accessed 03 March 2021.