Programs of All-inclusive Care for the Elderly effective in keeping seniors out of nursing homes
Alexandria, VA – Programs of All-inclusive Care for
the Elderly (PACE) were one of three programs researchers identified
as models of long term care that are effective, efficient and less
expensive than traditional long term care in a study whose findings
appear in the most recent issue of the Journal of the American Medical
Association (JAMA, November 3, 2010).
“PACE
organizations are proud of our success in keeping older adults with
long term care needs living in the community,” said National PACE
Association President and CEO Shawn Bloom. “This study helps to
explain some of the reasons why PACE is able to help so many families
who are challenged to find the best care possible for their older loved
ones.”
The researchers
examined all peer-reviewed studies of comprehensive primary care models
for older adults with multiple conditions published between 1999-2010.
From this review, they identified four processes that are present in
most successful models of primary care for these patients:
•Development
of a comprehensive patient assessment that includes a complete review
of all medical, psychosocial, lifestyle and values issues
•Creation and implementation of an evidenced-based plan of care that address all of the patient’s health needs.
•Communication and coordination with all who provide care for the patient.
•Promotion of the patient’s (and their family caregiver’s) engagement in their own health care.
“PACE
is innovative because it allows a team of health and service
professionals to take responsibility for all aspects of a senior’s
care,” Bloom said. “Because our payment does not change based on the
services we provide , we can be creative in delivering care and service
focused on the unique needs of each older adult and their family in the
right place, in the right measure and at the right time.”
PACE
is both financially and clinically responsible for enrollees when they
need hospital or nursing home care. The all-inclusive nature of PACE
provides financial incentives to provide less expensive primary and
preventive care.
“In
PACE the financial incentives are aligned with the clinical incentives,”
Bloom said. “We have found the flexibility this allows providers is
essential when caring for older individuals who often have complex
clinical and social needs.”
PACE
programs serve persons who are 55 and older, live in the PACE service
area, need a nursing home level of care, and are able to live safely in
the community at the time of enrollment. PACE has been successful at
enabling enrollees to continue living in the community by utilizing an
interdisciplinary team that both plans and delivers care for each
enrollee and a risk-based financing model that rewards effective
provision of preventive and primary care. PACE organizations are
responsible for all the care and services that each enrollee needs,
including hospital stays and nursing home placement.
PACE
is funded through Medicare, Medicaid and private finances. It has been
a recognized provider type since 1997. Currently there are 75 PACE
sponsors operating in 29 states with more programs on the way.
The
study was conducted by lead researchers Chad Boult, MD, MPH, MBA, Johns
Hopkins School of Public Health, Baltimore, MD and G. Darryl Wieland,
PhD, MPH, research director of Geriatrics Services at Richland Hospital,
Columbia, SC and USC Department of Medicine’s Clinical Geriatrics
faculty.
About NPA:
The
National PACE Association works to advance the efforts of Programs of
All-inclusive Care for the Elderly (PACE) to support, maintain,
safeguard and promote the provision of quality, comprehensive and
cost-effective health care services for frail older adults. More
information on NPA and PACE is available at www.npaonline.org.
