A Focus on the Program of All-Inclusive Care for the Elderly (PACE)

Area of Science:

• Gerontology
• Health Services Research
• Public Health Policy

Background:

• The Program of All-Inclusive Care for the Elderly (PACE) has historically been operated by nonprofit organizations for over 40 years.
• Nonprofit PACE is recognized for delivering quality, cost-effective community-based care for elderly individuals requiring nursing home level services.
• Recent authorization allows for-profit entities to operate PACE, requiring demonstration of comparable access, quality, and cost-effectiveness.

Purpose of the Study:

• To critique a 2013 study evaluating for-profit versus nonprofit PACE operations.
• To compare for-profit PACE with for-profit hospice models.
• To assess the evidence base for for-profit PACE quality relative to nonprofit PACE.

Main Methods:

• Critical analysis of existing research, specifically the 2013 study presented to Congress.
• Comparative analysis with the for-profit hospice sector.
• Evaluation of evidence regarding access, quality, and cost-effectiveness.

Main Results:

• The 2013 study's findings were instrumental in authorizing for-profit PACE providers.
• A comparison with for-profit hospice suggests potential concerns regarding quality and cost-effectiveness.
• Current evidence is deemed insufficient to equate the quality of care provided by for-profit PACE with that of nonprofit PACE.

Conclusions:

• There is inadequate evidence to conclude that for-profit PACE providers deliver care of equivalent quality to nonprofit PACE operators.
• Further research and rigorous evaluation are necessary to ascertain the impact of for-profit involvement in PACE.
• Policy decisions regarding for-profit PACE should be informed by comprehensive, high-quality evidence on care delivery.