The New York Times Calls PACE “the Underdog of Senior Care”
WASHINGTON, DC – March 15, 2022 – New momentum on Capitol Hill to expand Programs of All-Inclusive Care for the Elderly (PACE), driven by the pandemic and a rapidly aging population, may provide access to PACE for more than 1 million eligible Americans.
Several bills have been introduced to increase access to and expansion of PACE:
- PACE Plus Act: Introduced in the House and Senate (H.R. 6770/S. 1162), the PACE Plus Act would eradicate most federal impediments to expanding existing PACE programs and establishing new ones. The legislation also would streamline the administrative challenges experienced by PACE organizations as they seek to grow and expand.
- Elizabeth Dole Home Care Act: Introduced in the House (H.R. 6823), the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2022 would establish partnerships between PACE programs and Veterans Affairs Medical Centers (VAMCs) when a VAMC is within the service area of a PACE program.
- PACE Expanded Act: Similar in scope, this bipartisan bill is a subset of the PACE Plus Act. It has been introduced in the Senate (S. 3626) and is expected to be introduced in the House soon.
- PACE Part D Plan Choice Act: This legislation would address the high cost of PACE Part D premiums for Medicare-only PACE participants, which average over $1,000 per month. The bill has been introduced in the House (H.R. 4941) and is expected to be introduced in the Senate later in the year.
- Ensuring Parity in MA and PACE for Audio-Only Telehealth Act: This legislation (H.R. 2166/S.150) would enable PACE organizations to report diagnoses from audio-only telehealth encounters to the Centers for Medicare & Medicaid Services (CMS) for inclusion in the risk adjustment calculations for PACE payments.
- PACE-Specific Pilots: NPA continues to advocate strongly for the Center for Medicare & Medicaid Innovation (CMMI) to implement PACE-specific pilots to test enrolling new populations and other innovations.
- A recent New York Times article called PACE “the underdog of senior care,” stating, “The Program of All-Inclusive Care for the Elderly, funded by Medicare and Medicaid, has quietly succeeded in enabling older Americans to age in place.”
During the pandemic, PACE programs have demonstrated the strength of its person-centered model of care by keeping enrollees safe at home. The rates of COVID-19 infection and death among PACE enrollees were one-third those incurred by nursing home residents.
The Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services (HHS) issued a report last fall titled “Comparing Outcomes for Dual Eligible Beneficiaries in Integrated Care” that found PACE “stands out from our analysis as a consistently ‘high performer.’ We found that full-benefit dual eligible beneficiaries in PACE are significantly less likely to be hospitalized, to visit the ED, or to be institutionalized, while their mortality risk is not significantly higher, compared to regular MA enrollees.”
In a report outlining regulatory steps that could be taken to make PACE more accessible to middle-income families, the Milken Institute, a leading think tank, recommended PACE growth as a solution to the nation’s long-term care crisis.
“Americans often underestimate the type and level of care they will need as they age, specifically the services and supports necessary to maintain the essential functions of daily life. Central to PACE and its unique value proposition is the interdisciplinary team caring for each patient and the wrap-around services provided,” stated the report, titled “New Approaches to Long-Term Care Access for Middle-Income Households.”
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The National PACE Association (NPA) works to advance the efforts of PACE programs, which coordinate and provide preventive, primary, acute and long-term care services so older individuals can continue living in the community. The PACE model of care is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. For more information, visit www.NPAonline.org and follow @TweetNPA.