Program of All-Inclusive Care for the Elderly

The Program of All-Inclusive Care for the Elderly (PACE) is a capitated health care program that allows individuals who qualify for the level of care provided by a nursing home to remain in their communities instead. PACE meets a critical need in the continuum of care for frail elderly individuals, providing a high-quality, cost-effective, community-based alternative to institutionalization. This innovative program includes comprehensive care provided by an interdisciplinary team, a medical day program, patient care coordination, intensive work with families, and provision of transportation and home care as needed. As part of this program, PACE provides and pays for all medically necessary services, including primary care, hospital care, specialty care, and institutional long-term care; it is thus both a health care provider and an insurer. Each PACE program is a 3-way partnership between the Centers for Medicare & Medicaid Services (CMS), the Division of Medical Assistance in the North Carolina Department of Health and Human Services, and the health care organization operating the program. PACE was authorized as a permanent Medicare provider in 1997 and was approved as an optional Medicaid service in North Carolina in 2007. To enroll in PACE, an individual must qualify for the level of care provided by a skilled nursing facility, be 55 years of age or older, reside in an area served by PACE, and be able to live in the community with support. On average, PACE participants are 80 years old, have 8 medical conditions, and are taking up to 12 medications when