Developed in the 1970’s as a community project to keep elders in their homes, PACE is now caring for more than 16,000 elderly persons nationwide. PACE which stands for Program of All-Inclusive Care for the Elderly, provides continuous care and services offering individuals eligible for nursing home care the option of continuing to live in the community.
The average client is 80 and takes eight prescription medications. Participants have to be 55 or older, certified by their state to need nursing home care and be able to live safely in the community. Each separate PACE program receives a fixed amount per person from a patient’s state Medicaid program — usually 85% to 90% of estimated nursing home costs. Medicare funds come through a risk-adjusted formula in which the program receives more for sicker enrollees. PACE becomes both the patient’s insurer and care provider and is obliged to pay for all of the patient’s medical care from the point of enrollment forward. “Before, I was paying almost $1,000 a month for prescriptions,” said Theresa Doherty, 76, and member of PACE. “And now — nothing.”
Robert Kane, director of the Center on Aging at the University of Minnesota, says PACE has provided some important lessons on the value of integrating all the players on a patient’s medical team and having staff touch base routinely with patients outside of scheduled medical appointments. Unfortunately, Kane says that only about one in five people eligible for nursing home care actually ends up getting it. “When it comes to PACE patients, you hear, ‘There but for the grace of God I’d be in a nursing home,’ ” Kane says. “But all those people wouldn’t go to nursing homes. A substantial portion would be in some kind of community-based care system.”
Bruce Robinson, chief of Geriatrics at Sarasota Memorial Hospital in Florida, says that if PACE expanded greatly, the system might not be able to bear the cost. “It’s not a criticism of PACE itself,” he says. “Yet if you do the math, you’re going to say we can’t afford this for the country — not with all the Boomers coming along.” Hopefully such a case will not happen and PACE can continue to provide their excellent care and service for many years to come.
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