Program of All-Inclusive Care for the Elderly (PACE): For States New to PACE

We offer comprehensive strategic planning and technical consulting to inform the decision to implement, develop and launch PACE programs. Our services include conducting detailed feasibility studies to help states evaluate potential PACE enrollment, service areas, stakeholder concerns, program costs ,and administrative capacity in terms of staff and resources.

Market Analysis

We evaluate the viability of PACE in your state by using census data to develop a detailed market inventory of eligible participants by ZIP code. This inventory is enhanced with heat maps and data visualizations, providing decision-makers with clear insights into potentially viable PACE markets.

Service Area Analysis

Building on data from the Market Analysis, we identify which areas of your state are most suitable for PACE services. Our analysis includes drive times, population densities, existing waiver populations, and review of the current healthcare infrastructure to establish optimal service areas and maximize the impact of the PACE program.

Stakeholder Engagement

We design and implement comprehensive stakeholder engagement strategies, collaborating with providers and provider organizations, advocacy groups, community-based organizations, State agency leadership, and contracted vendors to measure and ensure broad-based support and effective program implementation.

Agency Capacity

We assess and enhance the administrative capacity of agencies to manage PACE programs effectively, ensuring they have the necessary staff, resources, and infrastructure to support program success. We integrate insights from the market analysis, service area analysis, and stakeholder engagement to provide agency leadership with the comprehensive information needed to make informed decisions about implementing PACE in your state.

AWOP Calculation, Rate Projection, Rate Setting, and Rate Adequacy

Federal law mandates that PACE rates must be less than what would otherwise have been paid (AWOP) under the State plan if participants were not enrolled in PACE. These rates should reflect the frailty of participants, be set at a fixed amount, and can be renegotiated annually. Our team collaborates with actuaries to gather relevant data and calculate your state’s unique AWOP. We provide detailed projections of potential PACE rates if the program is elected as a service in your state plan, and conduct thorough analyses to ensure these rates are sufficient to attract PACE providers.

For More Information:

Jared B. Duzan, CFE
Principal
PH: 317.815.2925
jduzan@mslc.com

Vicki Bartlett, RN, CCM, COC
Director
PH: 404.524.9052
vbartlett@mslc.com

Lydia Powell, CPA
Senior Manager
PH 509.695.6870
lpowell@mslc.com

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