PACE^® Model Practices

NPA's Primary Care Committee has developed the following model practices:

Diabetes Mellitus - 2009
Chronic Heart Failure - 2011
Chronic Kidney Disease - 2011
Chronic Obstructive Pulmonary Disease - 2012
Preventive Care Guideline - 2010

The model practices provide relevant diagnostic and treatment recommendations to PACE primary care physicians (PCPs).  They were were adapted specifically for PACE participants from evidence-based published guidelines for older adults, and are offered with the belief that shared decision-making between individual PCPs and participants/caregivers is optimal.  The model practices are not intended to replace the clinical judgment of the individual provider or to establish a standard of care.

PACE participants are a heterogeneous group, with differing health profiles, prognoses, preferences, and goals of care.  Life expectancy and quality of life issues require an individualized context within which to apply practice guidelines that may have been developed from and for a population of non-frail adults.  Whether a PCP follows any of the summary recommendations for an individual participant will depend upon factors specific to that participant, including the participant's preference, prognosis and life expectancy, co-morbid conditions, functional status, and goals of care.

The model practices assume that the goals of care for PACE participants can be divided into three broad categories:  promoting longevity, optimizing function, and palliative care.  Accordingly, the model practices suggest different approaches depending on whether the goal is life-extension, function, or palliation.  The PCP will need to determine which recommendations are appropriate for each individual participant, considering the participant's preferences, life-expectancy, and the expected benefit versus burdens of specific interventions.

NPA encourages the use and distribution of the model practices.  NPA members may obtain the documents from the Members Only/Primary Care Resources/Model Practices section of the web site. Non-member clinicians or organizations may not use, reproduce or modify the model practices without the expressed written consent of the National PACE Association.  Please contact Rhonda Rose at info@npaonline.org to obtain permission.