What Is PACE?
Programs of All-Inclusive Care for the Elderly (PACE) serves Medicaid and Medicare participants with comprehensive, long-term services and support. For most participants, PACE allows them to live and receive care in their community rather than at a residential facility for as long as possible.
PACE programs offer access to the entire continuum of healthcare services, including:
- Preventive care
- Primary and specialty care
- Emergency and inpatient care coordination
- Long-term care
- End of life care
- Transportation
- At-home services
The PACE model
The PACE model of care allows states to provide services to Medicare and Medicaid beneficiaries. To qualify, participants:
- Must be 55 or older
- Live in specified service areas
- Meet nursing home eligibility per state requirements
- Live safely in the community at the time of enrollment
According to the Balanced Budget Act of 1997, which established PACE under Medicare and Medicaid, organizations can apply to become PACE providers through a three-way agreement between PACE, the Centers for Medicare and Medicaid Services (CMS), and State Administering Agencies (SAAs). Financing for the program is capped, which allows providers to deliver participants all necessary services. Medicare rates are adjusted for demographic and diagnostic characteristics; Medicaid rates vary by state.
95% of PACE participants continue to live in their communities1
Why it works
PACE organizations fully integrate all Medicare and Medicaid services into one package to provide services to participants as they need them and not according to fee-for-service schedules, leading to better outcomes and lower healthcare costs. Interdisciplinary teams provide and coordinate all care for the individual, so PACE participants experience fewer emergency department (ED) visits, hospitalizations, and nursing home admissions. They also enjoy a higher quality of life while staying in their homes and communities.
Looking to start a PACE program?
Our experienced team can help your organization determine the feasibility of a PACE program, including state compatibility, and guide you through the PACE application and development process. We help you consider capital, break-even, and development time frame and complexity.
History
As a concept, PACE began in the early 1970s in San Francisco, California. Since then, it has grown into a permanent Medicare- and Medicaid-funded state-optional program, serving 60,000+ participants in 32 states.
PACE through the years2
Celebrating National PACE Association’s 20th Anniversary
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