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PACE: Allowing Older Adults to Remain in Their Homes

As those in the home healthcare industry know, the elder population is growing exponentially, and so too is their need for care. One of the more innovative programs available to help seniors age in place has actually been around for more than 50 years. The Program of All-Inclusive Care for the Elderly, or PACE, is a model centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in their community whenever possible.

What is PACE?

According to Shawn M. Bloom, President and CEO of the National PACE Association, the PACE model of care can trace its roots to San Francisco, where families in the 1970s were seeking solutions to the long-term care needs of the elder population. Community leaders came together and formed a nonprofit corporation called On Lok Senior Health Services to create a community-based system of care. On Lok is Cantonese for “peaceful, happy abode.” Today, there are more than 131 PACE programs in 31 states, serving approximately 60,000 seniors.

To be eligible for PACE, individuals must be 55 years of age or older, live within the PACE service area and be nursing home eligible as determined by their state. The program combines Medicare, Medicaid and all medically necessary care providers into a single provider organization. For a fixed cost, PACE is able to deliver innovative, comprehensive and creative care to help individuals continue to live at home and in their communities.

Interdisciplinary Care Approach

According to Bloom, when an individual enrolls in PACE, an entire interdisciplinary team – physicians, nurses, social workers, occupational therapists, physical therapists, transportation services, home care coordinators, dietitians and more – come together and meet daily to develop a plan of care to effectively help meet the needs of the individuals in the program. A primary goal of the program is to reduce the need for hospitalizations and nursing homes, and to help individuals reach their health and wellness goals. The PACE program routinely reports that a mere 5% of the people enrolled in the program are in nursing homes, and on average PACE participants spend only 2 days per year in the hospital to manage chronic diseases.

For PACE program participants, care is paid by Medicare, Medicaid or private payment. Once enrolled, the comprehensive program includes all of their healthcare needs, allowing creativity in the approach to how care is delivered. Beyond providing healthcare and helping participants manage chronic health conditions, this may include building ramps and making home improvements to help maintain accessibility and independence.

How the PACE Program Works

According to Bloom, an individual who is enrolled in the program lives at home with a caregiver or family member, and several times per week (up to daily, Monday through Friday), the PACE transportation bus takes that individual to his or her local PACE center. Once there, the individual can access a variety of healthcare-related services. The focal point of the PACE center is the day program, where participants are served lunch and given an opportunity to socialize and engage in a variety of activities. During their time at the center, staff may help participants by doing laundry, refilling their med sets, or packing a meal to take home for dinner that evening. PACE also provides in-home services for participants on days when they do not go to the center.

PACE is focused on person-centered care, offering participants a comprehensive assessment that looks at social, medical, environmental and family issues in order to develop specialized, individual care for each participant. PACE works with participants to determine goals of care – comfort care, longevity goals, or functional care – and intervenes clinically, socially and emotionally to support these goals at each stage of life to allow people to live independently and with dignity.

While the cost of the PACE program is set by each state, it is typically half the cost of nursing home care. Bloom indicates that as the senior population continues to grow, states are looking for the best and most efficient ways to care for their elder population, and questioning whether insurance companies are a good care delivery mechanism for older adults. PACE programs provide a robust and comprehensive model of care that is cost-effective, demonstrates positive outcomes, and provides exceptionally well-rounded care to help people remain in their homes. With a fixed rate no matter what services the participant needs, and a 95% chance of remaining at home, Bloom believes there continue to be exciting opportunities for growth and expansion of the PACE program in the years to come.

The Help Choose Home Podcast

Listen to the full interview with Shawn Bloom in the Help Choose Home podcast series to learn more. This episode and others in the series can be found on Apple Podcasts or Google.

The Help Choose Home podcast series provides information and resources for families about senior home health options. Podcasts are hosted by Merrily Orsini, executive vice president of Axxess and president and CEO of corecubed, an award-winning home care marketing solutions agency.

Help Choose Home is a collaborative effort by the National Association for Home Care and Hospice (NAHC), Axxess, and corecubed to educate the public about the many benefits of the in-home care industry, which includes non-medical home care, private duty nursing care, medical home health, hospice, and other in-home health and wellness services.

If this episode has been helpful, be sure to leave a five-star review and share the podcast with your friends to help us in the national effort to help choose home! You can connect with Merrily Orsini on Twitter @MerrilyO.

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