Stability of disability among PACE enrollees: financial and programmatic implications

Area of Science:

• Gerontology
• Health Services Research
• Public Health Policy

Background:

• The Program of All-inclusive Care for the Elderly (PACE) is an integrated care model for frail elders.
• Understanding participant outcomes and program variations is crucial for optimizing care delivery.
• The study focuses on the initial cohort of PACE programs to inform future expansion.

Purpose of the Study:

• To evaluate the functional status changes in PACE participants.
• To analyze the relationship between enrollment duration, risk characteristics, and functional status.
• To identify factors influencing functional improvement for quality enhancement.

Main Methods:

• Retrospective analysis of data from the first 11 PACE programs.
• Assessment of participant functional status in relation to enrollment length and individual risk factors.
• Statistical analysis to determine predictors of functional status improvement.

Main Results:

• Mature PACE programs demonstrated a stable mix of participant disabilities over time.
• Significant variations in participant characteristics and outcomes were observed across different PACE programs.
• Patient characteristics at admission were linked to the likelihood of functional status improvement, highlighting areas for targeted interventions.

Conclusions:

• The stability of the disability mix supports the current PACE payment structure.
• Program-specific payment rates may be warranted due to inter-program variability.
• Identifying patient risk factors at admission can guide quality improvement initiatives within PACE programs.