PACE: Program of All-Inclusive Care for the Elderly

The Program of All-Inclusive Care for the Elderly (PACE) is a long-term care model that uses an interdisciplinary health care approach to assess the needs of each participant and deliver a comprehensive array of services. All of this with one goal in mind: keep seniors healthy and living in their own communities for as long as possible.

Guided by directives from The Centers for Medicare & Medicaid Services (CMS), PACE provides seamless, coordinated health care services with improved efficiency and better outcomes. It is one of the few programs of its kind that integrates Medicaid and Medicare under a collaborative contract between CMS, state agencies and providers. This fully integrated model of care allows for greater service flexibility, coordination, and continuity of care.

PACE gives states a robust model to achieve the Medicaid long-term care objective of keeping seniors out of institutional placements and in the community. However, the intricate nature of PACE—where regulatory, medical, social, and healthcare delivery needs converge—makes its implementation a significant undertaking. Although most states have developed PACE programs, the model remains unique enough to present uncommon challenges that public administrators may not have encountered. For example, Federal law requires that PACE payment rates be less than what would otherwise have been paid (AWOP) under the Medicaid state plan if participants were not enrolled in PACE. The rates should also account for frailty of participants, be set at a fixed amount, and must be renegotiated on an annual basis.