Programs of All-inclusive Care for the Elderly (PACE) serve seniors with chronic care needs by providing access to the full continuum of preventive, primary, acute, and long term care services. PACE Programs California take many familiar elements of our traditional health care system and reorganize them in a way that makes sense to families, health care providers and the government programs and others that pay for care.
What is PACE and how is PACE Paid for?
What is PACE? PACE is a fully capitated program in which the Centers for Medicare PACE Program and Medicaid Services (CMS) pays the Medicare capitation, and each State establishes and pays the Medicaid capitation. These capitated payments are combined at the provider level, creating a flexible funding pool for all primary, acute and long term care services.
The goal of rate setting for PACE is to establish capitation rates that are acceptable to both providers and payers. In general, the Medicare capitation payment is about one-third of the payment PACE providers receive for each enrollee.
Who is Program of All Inclusive Care for the Elderly (PACE) for?
For consumers, PACE provides:
- Caregivers who listen to and can respond to their individualized care needs
- The option to continue living in the community as long as possible
- One-stop shopping for all health care services
For health care providers, PACE provides:
- Capitated funding arrangement rewards providers that are flexible and creative in providing the best care possible
- Ability to coordinate care for the individuals across settings and medical disciplines
- Meets increasing consumer demands for individualized care and supportive services arrangements
For those who pay for care, PACE provides:
- Cost savings and predictable expenditures
- Comprehensive service package emphasizing preventive care that is usually less expensive and more effective than acute care
- A model of choice for older individuals focused on in home services for seniors
Why Consider PACE for the Future
- PACE provides a full range of preventive, primary, acute and long term care services that enable frail older individuals to live in the community as independently as possible
- PACE provides care and services consistent with emerging consumer demands for individual choices in health care and services
- PACE combines adult day settings, home care, interdisciplinary teams, transportation systems and capitated payment systems so that providers can respond to the unique needs of each frail elderly individual served
- Twenty-six providers have successfully replicated the PACE model, demonstrating the value of high quality, individualized care PACE provides for its participants. Eleven other providers are operational and on their way to developing PACE programs
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