Program of All-Inclusive Care for the Elderly

PACE (Program of All-Inclusive Care for the Elderly) is a center that provides government-funded medical care and social services to people older than 55 whose financial medicinal needs qualify them for nursing home care but are able to live at home with the right kind of assistance.

PACE began in the early 1970s when community leaders in a San Francisco neighborhood were looking for care for their elders who had mainly emigrated from China, Italy, and the Philippines. The leaders all agreed that nursing homes were out of the picture as they were cost-prohibitive and culturally inappropriate, so they formed a non-profit that provided long-term elder care. The original name was On Lok, which is a Cantonese term that means
“peaceful, happy abode.” On Lok eventually became the first PACE center.

A 2014 study found that clients of PACE had lower hospitalization rates than similar populations who were not enrolled in PACE programs. PACE was strictly a nonprofit model for many decades, but about ten years ago, Congress allowed for-profit companies to open PACE centers. PACE centers are now nationally owned by a variety of healthcare organizations, which include nonprofits, for-profit companies, large healthcare systems, and religious organizations. See article from stateline here.

By 2030, 1 in 5 Americans will be over the age of 65, and most families are trying to find alternatives to nursing homes. Most adults say that they would prefer to live in their homes for as long as possible. Today, more than 160 PACE centers operate in 32 states. More than 72,000 people are enrolled in PACE compared to more than 1 million nursing home residents. Most PACE clients are enrolled in Medicare and Medicaid. A member from the National PACE Association said, “One of the things about COVID is that it really focused attention on long-term care because of the experience that nursing homes had.” What’s so special about PACE is that it can keep people at home and could potentially cost less than nursing home care.

After a state Medicaid program decides to cover PACE care, the providers will receive a fixed monthly payment from Medicare and Medicaid for each enrolled client. Medicaid and Medicare services don’t require states to provide PACE services, but in the states that have them, about 90% of clients qualify for both. Although PACE care has fallen short over the years, it has recently gained attention from lawmakers in states such as Georgia, Illinois, and Ohio. Ohio Republican Gov. Mike DeWine announced that the state will be opening new PACE programs in nine counties, which makes Ohio’s PACE expansion the largest that’s currently underway.

In January, New Jersey Democratic Gov. Phil Murphy signed a bill that will make the enrollment of clients easier. Illinois will also launch seven new PACE centers throughout the state in June. In Georgia, a bill is awaiting signature from Republican Gov. Brian Kemp to create carve-outs in the state to allow for PACE centers to open. Additionally, Tennessee lawmakers are working together to consider passing a bill that would direct the state’s Medicaid program,
TennCare, to establish PACE statewide. South Carolina refuses to do anything to help vulnerable adults.