As outlined in part one of our PACE blog series, The Program of All-Inclusive Care for the Elderly (PACE) offers comprehensive medical care and social services tailored to seniors who wish to maintain independent in their homes. Below, we delve into the qualifications for enrollment, the intricate procedures involved in administering PACE, and the crucial responsibilities of providers in delivering high-quality, personalized care to participants, ensuring their health and well-being are prioritized and supported.
As mentioned in the previous PACE article, qualifications to enroll in the program include:
However, there are some restrictions to those eligible, including:
Eligible individuals must first meet the qualifications above, voluntarily enroll, sign an enrollment agreement, and provide necessary medical and personal information. This ensures that the provided care team can meet the individuals’ needs and determine what services will need to be provided.1 Enrollment is continuous, unless participants choose to disenroll or are dropped from the program.
The PACE program has countless benefits for eligible enrollees including, but not limited to all Medicaid and Medicare covered services, such as:
PACE providers are an integral part of ensuring the program provides the necessary care for every individual who needs the support. The wide range of different medical and social service providers must work together to ensure that the best quality care is performed, compliance is met, and patients and their families are supported during difficult times. Learning how to administer the program, operate as a team, and understand the qualifications and guidelines will be essential for a smooth transition.
PACE organizations can be non-profit, private or public entities that deliver PACE services. Their goal is to help you live in the community for as long as possible, which requires a large focus on preventative care. With the help of PACE organizations, many of their patients meet this goal with only 7% living in nursing homes.3
Qualifications:
Since PACE is a provider-sponsored health plan, your doctor and other providers also work with you to make decisions about your care.3 A PACE team can consist of a primary care physician, nurses, social workers, therapists, dietitians, etc. These teams collaborate to create individualized care plans, ensuring comprehensive and coordinated support for each participant.
By adhering to these guidelines, PACE organizations ensure that elderly participants receive comprehensive, high-quality care in their communities.
This blog was originally published as "Navigating PACE: Understanding Patient and Provider Roles" by Shea Swenson on 9/3/24, for Maxwell Healthcare Associates. The Maxwell TEC editorial team has since updated this article to ensure accuracy and relevance.