Medicare PACE program helps older adults
The Medicaid and Medicare PACE program (Program of All-inclusive Care for the Elderly) provides a wide range of social and medical services at adult day health centers, inpatient facilities and at home. PACE participants are community-dwelling elderly individuals and are typically eligible for both Medicare and Medicaid benefits. PACE enables them to receive nursing home levels of care at home as long as possible and out of the hospital. According to medicaid.gov, financing for the program is capped, allowing providers to deliver all services participants need rather than limit them to those reimbursable under Medicare and Medicaid fee-for-service plans. The PACE model of care is established as a provider in the Medicare program and enables states to provide PACE services to Medicaid beneficiaries as a state option.
National PACE Association
Currently, 50,000 enrollees participate in PACE programs at over 260 centers in 31 states. And about 2/3 of PACE participants have some degree of cognitive impairment. The National PACE Association said data it collected for 2019 shows seniors enrolled in PACE cost states 13% less on average than the cost of caring for them through other Medicaid-funded services, including nursing homes. The PACE program is more important than ever as the senior population increases across the country.
How PACE helps real people
Kaiser Health News shares a story of a 65-year-old PACE participant named Perez living in California. Two days a week, a van takes Perez to and from a senior center in his home town. There he eats a hot lunch, plays cards and gets physical therapy to help restore the balance he lost after breaking both legs in a fall. Participants at the center play games like bingo or Trivial Pursuit. They can shower, get their hair done or even get dental care. In addition, aides bring Perez grocery shopping twice a week. The added benefit of social interaction gives him something to look forward to every day.
Eligibility and services offered by PACE
To join, individuals must be 55 or older, live in the PACE service area, eligible for nursing home care and be able to live safely in the community.
Below is a list of services offered by PACE:
- Adult daycare
- Emergency services
- Home care
- Hospital care
- Laboratory/x-ray services
- Medical specialty services
- Nursing home care
- Nutritional counseling
- Occupational therapy
- Physical therapy
- Prescription drugs
- Primary care (including doctor & nursing services)
- Recreational therapy
- Social services
- Social work counseling
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