PACE programs serve persons who are 55 and older, live in the PACE service area, need a nursing home level of care, and are able to live safely in the community at the time of enrollment. PACE has been successful at enabling enrollees to continue living in the community by utilizing an interdisciplinary team that both plans and delivers care for each enrollee and a risk-based financing model that rewards effective provision of preventive and primary care. PACE organizations are responsible for all the care and services that each enrollee needs, including hospital stays and nursing home placement.
PACE is funded through Medicare, Medicaid and private finances. It has been a recognized provider type since 1997. Currently there are 75 PACE sponsors operating in 29 states with more programs on the way.
Programs of All-inclusive Care for the Elderly (PACE) were one of three programs researchers identified as models of long term care that are effective, efficient and less expensive than traditional long term care in a study whose findings appear in the most recent issue of the Journal of the American Medical Association (JAMA, November 3, 2010).
The researchers examined all peer-reviewed studies of comprehensive primary care models for older adults with multiple conditions published between 1999-2010. From this review, they identified four processes that are present in most successful models of primary care for these patients:
•Development of a comprehensive patient assessment that includes a complete review of all medical, psychosocial, lifestyle and values issues
•Creation and implementation of an evidenced-based plan of care that address all of the patient’s health needs.
•Communication and coordination with all who provide care for the patient.
•Promotion of the patient’s (and their family caregiver’s) engagement in their own health care.
“PACE is innovative because it allows a team of health and service professionals to take responsibility for all aspects of a senior’s care,” Bloom said. “Because our payment does not change based on the services we provide , we can be creative in delivering care and service focused on the unique needs of each older adult and their family in the right place, in the right measure and at the right time.”
PACE is both financially and clinically responsible for enrollees when they need hospital or nursing home care. The all-inclusive nature of PACE provides financial incentives to provide less expensive primary and preventive care.
The study was conducted by lead researchers Chad Boult, MD, MPH, MBA, Johns Hopkins School of Public Health, Baltimore, MD and G. Darryl Wieland, PhD, MPH, research director of Geriatrics Services at Richland Hospital, Columbia, SC and USC Department of Medicine’s Clinical Geriatrics faculty.
The National PACE Association works to advance the efforts of Programs of All-inclusive Care for the Elderly (PACE) to support, maintain, safeguard and promote the provision of quality, comprehensive and cost-effective health care services for frail older adults. More information on NPA and PACE is available at www.npaonline.org.
Vice President of Public Affairs
National PACE Association
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