Programs of All-Inclusive Care for the Elderly (PACE): Designed for community-dwelling older adults who are most often dually eligible for Medicare and Medicaid.
Target Group: Older adults, particularly those eligible for both Medicare and Medicaid benefits.
Service Delivery:
An interdisciplinary team of health professionals delivers coordinated care.
Services enable individuals to remain in their communities instead of receiving care in nursing facilities.
Financing Structure:
Capitated Financing: Allows providers to offer all necessary services rather than being restricted to only those covered under traditional Medicare and Medicaid fee-for-service plans.
Cost Management:
PACE limits out-of-pocket costs for participants by eliminating deductibles, copayments, and other forms of cost-sharing.
When a participant needs to use a noncontract provider, there are limits on charges made by these noncontract entities to the PACE program.
Status of the Program:
PACE functions as a Medicare program that states can opt to implement for Medicaid beneficiaries as an added benefit.
Upon implementation, PACE serves as the sole source of Medicaid and Medicare benefits for its participants.
Establishment: PACE is recognized as a distinct provider within the Medicare program, ensuring complete integration of care for participants.