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PACE: has it changed the chronic care paradigm?
Marty Lynch1, Mauro Hernandez, Carroll Estes
1Lifelong Medical Center, P.O. Box 11247, Berkeley, CA, USA. MartyL@LifeLongMedical.org
Social Work in Public Health
|February 14, 2009
Summary
The Program of All-inclusive Care for the Elderly (PACE) integrates medical and long-term care, influencing policy. However, its limited enrollment shows minimal structural change in the long-term care industry.
Area of Science:
- Gerontology and Health Services Research
- Public Health Policy and Management
Background:
- The Program of All-inclusive Care for the Elderly (PACE) originated as a community-based initiative.
- PACE has been replicated nationally by non-profit organizations, serving elders with chronic care needs.
Purpose of the Study:
- To review the documented successes of the PACE model.
- To analyze the factors limiting PACE's growth and its policy influence.
- To assess PACE's impact on the structure of the long-term care industry.
Main Methods:
- Literature review of published PACE program outcomes and analyses.
- Discussion of policy implications and industry influence.
- Evaluation of enrollment data in relation to industry-wide structural change.
Main Results:
- PACE successfully integrates medical and long-term care, influencing policy and breaking down funding silos.
- PACE serves as a model for Medicare and Medicaid, with potential lessons for private insurers.
- Limited nationwide enrollment (just over 10,000 elders) indicates minimal structural impact on the for-profit nursing home industry.
Conclusions:
- PACE has significantly advanced the conceptualization of integrated care for the elderly.
- Its model has influenced long-term care policy at state and federal levels.
- Despite its influence, PACE has not yet driven substantial structural transformation in the broader long-term care market.
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