The National PACE Association (NPA) has implemented the following strategic initiatives.
Enacted into law in 2009 as part of the American Recovery and Reinvestment Act (ARRA), the Health Information Technology for Economic and Clinical Health (HITECH) Act developed the Medicaid and Medicare Electronic Health Incentive programs. The programs were created in 2011 to provide financial incentives that encourage eligible professionals and hospitals to adopt, implement, upgrade and demonstrate meaningful use of certified electronic health record (EHR) technology. Because PACE clinical staff members are eligible professionals, NPA has been following the rules closely and supporting PACE organizations that choose to enroll clinical staff willing to reassign incentive funds to the PACE program. The primary objectives of NPA in support of its members are to undertake efforts to assure that PACE organizations have access to the financial incentives to purchase and implement EHRs and to assure that EHR products are applicable to PACE.
NPA convened a workgroup to look at variations that allow the model to grow more quickly and serve more people.
NPA worked with members and other stakeholders to identify individuals who might benefit from a program based on the PACE Model of Care but who PACE organizations cannot currently serve because of the limitation of the PACE statute.
NPA is working with its members, the Centers for Medicare & Medicaid Services (CMS), and Congress to adapt the PACE model to serve other high-need, high-cost populations, such as individuals with intellectual or physical disabilities or persons with multiple chronic conditions.
The PACE Pilot Act has paved the way for a new era. The act provides the Center for Medicare and Medicaid Innovation (CMMI) the authority to develop PACE pilots for new populations. CMMI has delegated the responsibility for developing the pilots to the Medicare-Medicaid Coordination Office, also known as the Duals Office. The range of populations that could be included in the pilots is broad, including people under age 55 with a disability, individuals at risk of needing a nursing home level of care or with complex medical needs in combination with functional limitations, and those with behavioral health conditions.
NPA participated in a workgroup of disability community stakeholders to consider how the PACE model might be adapted to serve this new population. The stakeholders worked together to develop an Adapted PACE Protocol that builds on the current PACE program design and adapts it to address the needs and concerns of younger people with disabilities. The workgroup hosted a webinar on the Adapted PACE Protocol titled PACE Pilots: A New Era for Individuals with Disabilities on Aug. 24. You also can view the accompanying slide presentation.
In 2006 CMS issued the Rural PACE Provider Grant Program, which provided 15 grantees with $500,000 each to support the development of a rural PACE program. NPA and the National Rural Health Association (NRHA) received a contract from the Health Resources and Services Administration in the U.S. Department of Health and Human Services for the Rural PACE Technical Assistance Program (RP-TAP), which produced resources for and provided technical assistance to organizations interested in developing a PACE program to serve a rural area.
In 2009 the Veterans Health Administration launched Patient-Centered Alternatives to Institutional Extended Care Transformation-21 (T-21). Since 2009, the T-21 program has provided start-up funding to Veterans Affairs Medical Centers (VAMCs) to develop innovative clinical programs that offer patient-centered alternatives to institutional care that can successfully support frail veterans at home. As a result of several rounds of T-21 and other grant funding, there are now 10 VAMCs collaborating with 16 PACE organizations to offer PACE services to nursing home-eligible veterans.
For more information, contact Sam Kunjukunju, director of Project Management at NPA.