Funding elder care is a growing challenge for individuals, families, and our nation. One response to the challenge has been a little-known program called PACE – Program for All-Inclusive Care of the Elderly. PACE is an optional benefit under both Medicare and Medicaid that focuses entirely on older people who are frail enough to meet their State’s standards for nursing home care. It features comprehensive medical and social services that can be provided at an adult day health center, home, and/or inpatient facilities. This comprehensive service package permits most patients to continue living at home while receiving services.
PACE may, however, be the best-kept secret in the field of elder care. According to recent article in the Providence (Rhode Island) Journal, PACE programs serve only about 22,000 people nationwide. PACE is available only in States that have chosen to offer it under Medicaid. Hawaii is one of those States, but the only active local PACE program is offered through Hale Makua on Maui. It is currently unclear whether the program will be expanded to other local communities.
PACE’s financing arrangement allows for a great deal of flexibility. Medicare and Medicaid both pay a set amount of money for each patient, instead of reimbursing for each service and specifying which services are covered. PACE then has the freedom to use the money in whatever way best serves the patients’ needs. This could include things that are not normally paid for by Medicare, such as an air conditioner for an asthma patient.
PACE teams include primary care physicians and nurses; physical, occupational and recreational therapists; social workers; personal care attendants; dietitians; and drivers.