Special Report Highlights Flexibility and Resiliency of PACE Model in Response to Pandemic

October 22, 2020

A special report by the National PACE Association (NPA) and Altarum highlights how Programs of All-Inclusive Care for the Elderly (PACE®) have been effective in keeping nursing home-eligible enrollees safe in the community during the COVID-19 pandemic. PACE uses an interdisciplinary team approach that enables 95 percent of its enrollees to continue to live in the community and outside of a nursing home. Its normal model of care of providing transportation for enrollees and attendance at PACE centers where they received social, nutritional, medical, personal care and other services has been challenged during the pandemic.

“It has been inspiring to watch our PACE programs develop innovations out of their commitment to keep their enrollees as safe as possible during this pandemic,” said Shawn Bloom, president and CEO of NPA. “It has been gratifying that NPA, as the national association for PACE organizations, has been able to play a role in helping the PACE community spread and refine these innovations.”

Traditionally, PACE interdisciplinary teams have used a PACE center, vans, and a network of community providers to build relationships and deliver care to PACE enrollees. While some home care always has been provided to participants by PACE programs, the pandemic spurred PACE teams to devise and employ innovative care delivery approaches to prevent the spread of COVID-19 in this highly vulnerable population.

PACE programs developed a range of effective innovations for delivering high-quality care safely in the community. NPA and Altarum have partnered to apply for federal grant funding to document these innovations.

“The story of PACE adaptations during the pandemic shows many organizations are capable of making rapid changes to their service delivery to keep participants as safe as possible, and the very low reported death rates from the virus demonstrates they have been successful,” said Anne Montgomery, co-director of the Program to Improve Eldercare at Altarum, a nonprofit organization that works with public and private insurers, provider organizations and foundations to improve the health of vulnerable and publicly insured populations. “In the process PACE organizations have devised ways to move many services to the home and have gone the extra mile to ensure their participants are neither lonely nor isolated.”

PACE implemented a number of rapid responses to keep enrollees safe and cared for during the pandemic:

  • retraining clinic-based staff to support enrollees in the home;
  • implementing telehealth technologies in the home to conduct virtual care visits;
  • while PACE centers were closed, clinics at the centers were kept open and safeguards developed for enrollee visits;
  • vans normally used to transport participants to PACE centers were reassigned to deliver home-based care and services, nutrition services, durable medical equipment, medications and more;
  • PACE centers were repurposed as infirmaries to provide 24-hour care for participants with COVID-19;
  • PACE centers offered respite care, including overnight stays, for families who needed a safe place for their elderly loved ones when they worked or needed a break;
  • mobile clinics were launched; and
  • new programming was developed to combat the social isolation of enrollees and support family caregivers.

A total of 135 organizations operate PACE programs in 31 states across the United States. More than 54,000 people are enrolled in PACE. Enrollees are age 55 and over and meet their state definition of needing nursing home care. Less than 7 percent (6.64 percent) of PACE enrollees have tested positive for COVID-19, and 1.66 percent have died of COVIID-19, a rate below other care models serving nursing home-eligible individuals, according to data collected by NPA.

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