All Inclusive Care for the Elderly (PACE) programs are enjoying a moment in the limelight, as the Biden administration and Congressional Democrats scramble to expand home and community services. But during a webinar on Wednesday sponsored by healthcare advocacy group Altarum, administrators at PACE said accessibility and policy changes needed to be addressed in Washington, DC, in order for the program to grow.
“I believe the pandemic has taught people that you can provide high quality, high acuity care at home and the consumer is waiting for that to happen,” said Scott LaRue, President and CEO of ArchCare, based in New York. “I think the pandemic has accelerated this by at least 10 years. ”
PACE is a Medicare and Medicaid-funded program that keeps people over the age of 55 – who need skilled nursing care – at home. The program provides medical care, therapy, meals and socialization at PACE centers. It is available in 31 states and serves around 55,000 people, but Altarum estimates that between 10 and 12 million people over the age of 65 in need of long-term care services could benefit from PACE.
Move to expand access
Making the program accessible to a wider population is crucial, according to LaRue. Currently, only beneficiaries with dual Medicare and Medicaid eligibility can benefit from PACE services. Medicare registrants who are not eligible for Medicaid can pay for the program out of pocket, but it is expensive – between $ 900 and $ 11,000 per month.
LaRue said ArchCare is currently pushing the Center for Medicare and Medicaid Innovation to approve a pilot program that would allow Medicare-eligible seniors to access the program.
“It shouldn’t be that people have to wait until they have exhausted all of their assets or ended up in an institution before they can avail the services of the PACE program and we hope to advance that premise,” LaRue mentioned.
Other PACE administrators are asking for more innovation. During the pandemic, most PACE programs were forced to close their centers and provide care to clients at home.
Grace Li, executive director of San Francisco-based On Loc PACE, said the pandemic had taught her that transporting frail elderly by bus to an activity and medical center was not always the best plan.
“The pandemic has caused some of us to use telehealth more aggressively – even thinking of some of the activities for some of the elderly and future elderly who are now very adept at using technology,” he said. Li said.
PACE programs also face other challenges, including a cumbersome application process and access to capital.
Ready for expansion
The program could expand thanks to a handful of bills currently being issued in Washington. On Tuesday, Senate Democrats introduced a reconciliation bill that would include funding for home and community services, such as PACE. In April, Senator Bob Casey (D-PA) introduced the PACE Plus Act, which would fund new programs and expand existing ones.
“We have a lot of work to do, but we have a great opportunity over the next two years to build on the great work of PACE and improve and invest in home and community services,” Casey said in a recorded message during the webinar.
Last spring, Denver-based InnovAge became a publicly traded company, so it could tap capital markets with the goal of expanding to more of the five states where it currently operates centers. . InnovAge President and CEO Maureen Hewitt said McKnight’s Daily Home Care more and more states have recently expressed an interest in PACE. She believes the attention the program is getting from Washington is part of the reason.
“I think from an awareness factor which alone is important. Certainly, if there is increased Medicaid funding for home and community services or additional federal matches for PACE expansion, all of those things are really good, ”Hewitt said.