- On June 6, 2017
Programs of All-inclusive Care for the Elderly (PACE) have long been considered the gold standard in person-centered care delivery for community-dwelling, but nursing home qualified, dual-eligible seniors. PACE is poised to continue its significant growth of recent years.
Key developments that have created much deserved interest in PACE include:
- New opportunities for regulatory and enrollment flexibility through updated proposed regulations released in July 2016 and in the PACE Innovation Act of 2015;
- Faster time to market with a more efficient application process; and,
- New opportunity for previously discouraged for-profit program sponsorship.
These changes indicate that the Centers for Medicare and Medicaid Services (CMS) believes in the financial and clinical outcomes of PACE and is encouraging faster growth and expansion.
As recently as December 2016, CMS released a request for information seeking public input on potential adaptions to the PACE model of care and expansion to serve additional populations such as individuals with physical disabilities, those who are under 55, or those who have not yet reached nursing home eligibility. When viewed as a key population health management tool for select segments of medically complex individuals, ACOs, health systems, managed care organizations, and senior living communities are increasingly recognizing the symbiotic relationships possible with PACE.
Health Dimensions Group (HDG) is recognized as a leader in PACE consulting, successfully supporting several programs from application to start-up to program optimization. HDG’s PACE demand and pro forma analysis processes, which are critical to PACE feasibility analysis, are known in the industry as best practice and used by the National PACE Association (NPA).
Recently, HDG’s Lori Aronson was part of a presentation team sponsored by NPA to help programs strike the right balance between participant and family needs, and requests and appropriate utilization of necessary services. Discussion included the review of care management principles in the PACE setting and the practice of ensuring the right care, at the right time, in the right place, and in the right amount. The presentation also described how benchmarking can be used to identify areas of opportunity and best practices, and how uniform tools can be developed to guide decision making, while honoring the individual creativity of interdisciplinary team members.