What Is PACE?
Program of All-inclusive Care for the Elderly (PACE) are programs that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program.
Eligibility for PACE requires that individuals be 55 years old or older, certified by the state to need nursing home-level care, reside near a PACE program, and be able to live safely in the community. Services include primary and specialty medical care, nursing, social services, therapies (occupational, physical, speech, recreation, etc.), pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health.
How PACE works:
PACE programs become the insurance and the health care provider and are directly responsible for providing all health services and manage all aspects of their participant’s healthcare. PACE is paid through Medicaid and Medicare combined (dual eligible) or private pay on a monthly basis.
Most PACE patients have multiple diagnoses, with an average of over 7 diagnoses per member. Among the most common are cardiac problems, diabetes, hypertension, and vascular disease. PACE programs tend to provide high levels of preventive services, such as very frequent check-ups, exercise programs, dietary monitoring, programs to increase strength and balance, etc.
PACE programs organize their services in a "PACE Center". These Centers have a Day Center, medical clinic, social services and rehabilitation services, along with administrative staff, all in one site. Members attend centers from rarely to 5 days a week, depending on their care plans. Care planning is done with the member, his or her care team, and appropriate family members; most members attend about 2 days per week.
Editor’s note: This article was submitted by Leslie Mader. Leslie is the Manager of Outreach and Enrollment for TRU PACE based in Lafayette, CO. She may be reached at 303-665-0115 or firstname.lastname@example.org.
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Colorado - Boulder County