PACE programs are run by Medicare. They provide long-term care services to individuals who require skilled nursing care but wish to remain at home and maintain their quality of life. The primary objective of the PACE program is to help participants age in place, enabling them to stay in their communities and live at home for as long as they are safely able, with the goal of delaying or avoiding nursing home placement. The PACE program is considered an alternative to nursing home care, although if a participant requires nursing home care, it is covered by the PACE program.
PACE programs are not available in all states, and offerings vary from state to state. As of 2008, there were 61 PACE programs in 29 states. Participants must be at least 55 years old, live in an area served by a PACE program, and be certified as eligible for nursing home care.
PACE is an evidence-based model of care. The success of PACE programs has been measured in multiple studies that show an overall slower rate of decline in the functional status of PACE participants as compared with their peers in nursing homes. Most program participants are able to continue living at home comfortably, with support from the PACE program. In fact, according to the National PACE Association, although the need for skilled nursing care is a prerequisite to enrollment, “only about seven percent of PACE participants nationally reside in a nursing home.”
How PACE Programs Work
An interdisciplinary team of health and medical professionals as well as supportive service professionals conduct needs assessments, develop care plans and deliver the necessary services to each individual enrollee. PACE programs provide the same coverage as Medicare and Medicaid, in addition to care and services (deemed medically necessary by the interdisciplinary team) that are not covered by Medicare or Medicaid.
PACE providers receive monthly Medicare and Medicaid payments for each enrollee.
If you are a Medicare or Medicaid beneficiary, once you become a participant, the PACE program becomes your only source of long-term care services. If you run out of resources and can no longer pay, you can still receive benefits. Once you are enrolled in a PACE program, you may opt out at any time.
The PACE program provides comprehensive long-term care acute and supportive services. Covered care and services includes:
- Primary care, including doctors’ and nursing services
- Adult day care, including: nursing; physical, occupational and recreational therapies; meals; nutritional counseling; social work and custodial care
- Home health care and custodial care
- Necessary prescription drugs
- Medical specialty services, including audiology, dentistry, optometry, podiatry, and speech therapy
- Emergency services
- Laboratory and X-ray services
- Hospital and nursing home care when necessary
- Respite care
- Social services
- Basic transportation
Written by senior housing writer Nikki Jong.