Program of All Inclusive Care for the Elderly (PACE)
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Indications
- patients who qualify for nursing home care yet prefer to remain in their own homes
- patients with chronic disease necessitating reliable follow-up are good candidtes
Capitated benefit authorized by the Balanced Budget Act of 1997.
Features:
- comprehensive service delivery system
- adult day care
- integrated medical & social care
- primary care, specialty care, acute care, & home care
- some programs incorporate on-site mental health care[1]
- integrated Medicare-Medicaid financing
Permits most participants to continue living at home.
Capitated financing allows providers to deliver all needed services.
Patients not Medicaid eligible may enroll & pay equivalent of Medicaid share out-of-pocket[1]
Requirements:
- > 55 years of age
- must live in the PACE service area (primarily urban areas)
- certified by the appropriate state agency as eligible for nursing home care*
- patients must disenroll from their HMO Advantage plan
- must be able leave home[1] (use GRACE for home-bound patients)[1]
- transportation to & from the PACE center is provided
* (GRS9)[1] cites need of health oversight would suffice
- assesses participant needs
- develops care plans
- delivers all services
- includes acute care & nursing home services
- provides primary care provider thus patient cannot remain with their former primary care provider[1]
Medical & social services provided primarily in adult day health center, supplemented by in-home & referral services.
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019 - ↑ Ginsburg IF, Eng C. On-site mental health services for PACE (Program of All- inclusive Care for the Elderly) centers. J Am Med Dir Assoc. 2009 May;10(4):277-80 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19426945
- ↑ Mukamel DB, Peterson DR, Temkin-Greener H et al Program characteristics and enrollees' outcomes in the Program of All-Inclusive Care for the Elderly (PACE). Milbank Q. 2007 Sep;85(3):499-531. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17718666
- ↑ Wieland D, Boland R, Baskins J, Kinosian B. Five-year survival in a Program of All-inclusive Care for Elderly compared with alternative institutional and home- and community-based care. J Gerontol A Biol Sci Med Sci. 2010 Jul;65(7):721-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20354065
- ↑ Wieland D, Kinosian B, Stallard E, Boland R. Does Medicaid pay more to a program of all-inclusive care for the elderly (PACE) than for fee-for-service long-term care? J Gerontol A Biol Sci Med Sci. 2013 Jan;68(1):47-55. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22565242
- ↑ Segelman M, Szydlowski J, Kinosian B et al Hospitalizations in the Program of All-Inclusive Care for the Elderly. J Am Geriatr Soc. 2014 Feb;62(2):320-4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24417503
- ↑ Basheda L Government-Funded Day Care Helps Keep OAs out of Nursing Homes, Hospitals. Annals of Long-Term Care. Dec 27, 2019 https://www.managedhealthcareconnect.com/content/government-funded-day-care-helps-keep-oas-out-nursing-homes-hospitals
- ↑ Medicaid.gov Program of All-Inclusive Care for the Elderly (PACE) http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Integrating-Care/Program-of-All-Inclusive-Care-for-the-Elderly-PACE/Program-of-All-Inclusive-Care-for-the-Elderly-PACE.html
- ↑ Centers for Medicare & Medicaid Services (CMS) PACE Fact Sheet http://www.cms.gov/Medicare/Health-Plans/pace/downloads/PACEFactSheet.pdf