The Program of All-Inclusive Care for the Elderly (PACE)

Abstract

This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.

Analysis of the status quo of the Elderly’s demands of medical and elderly care combination in the underdeveloped regions of Western China and its influencing factors: a case study of Lanzhou

“…It provides basic medical services and daily care services. An all-round legal system is a major reason why the elderly nursing combining medical and elderly care has been well developed in Japan [ 14 ].…”

The Effects of a Variant of the Program for All‐inclusive Care of the Elderly on Hospital Utilization and Outcomes

“…The Wisconsin Partnership Program (WPP) is a managed care program serving frail older people and individuals who have physical disabilities. The State of Wisconsin initiated WPP in the late 1990s as an extension of the Program for All‐inclusive Care of the Elderly (PACE) 1,2 and expanded it to cover persons with disabilities in addition to frail older persons. Like PACE, WPP integrates funding from existing Medicaid and Medicare programs into one program through a series of federal Medicare and Medicaid waivers, allowing one fully capitated funding stream.…”

Problems in the home and community‐based long‐term care for the elderly in China: A content analysis of news coverage

“…8,21,22 According to the experience from the PACE program in the USA, it is necessary to train full-time staff through education programs if the PACE program wants to continue. 58 Home-care staff in European countries such as Greece, Italy and Austria are also not adequate. In China, there is a vast gap between supply and demand for the service staffs.…”