The Facts About PACE in Massachusetts

PACE ENROLLEES

  • All PACE enrollees meet the state’s definition of nursing home eligible
  • PACE enrollees are frail, with significant functional and chronic conditions
  • PACE enrollees are largely dually eligible, which means that they have coverage under the Medicare and Medicaid programs
  • PACE enrollees have many behavioral health conditions and many social determinant of health (SDOH) needs, including food, housing, social supports, and companionship to reduce loneliness and isolation

CHOICES ON MANY LEVELS

  • PACE enrollees have choice on many levels
  • PACE enrollees have choice over what they receive and how they receive services and supports from the PACE program
  • PACE provides care and services to enrollees in the community
  • PACE supports enrollees in what they would like to do every single day: older adults have the option to remain at home, go out into the community, or come to the PACE Center for a few days a week or not at all

SATISFACTION

  • PACE enrollees are satisfied
  • Very few PACE enrollees dis-enroll from the PACE program

INTEGRATION ON MANY LEVELS

  • Integration occurs on many levels: at the system level, at the program level, and on the individual level
  • Integration occurs between Medicare and Medicaid Services
  • Integration occurs through the Interdisciplinary Team
  • Integration “in action” takes place through the enrollee care plan

HOLISTIC APPROACH AND COMPREHENSIVE CARE

  • Every PACE enrollee has a holistic and comprehensive care plan
  • The enrollee’s care plan incorporates and addresses all needs ranging from medical to behavioral health to long-term services and supports to important social determinant of health (SDOH) needs such as food, transportation, and housing
  • PACE keeps people out of nursing homes, hospitals and away from the emergency department by emphasizing wellness and prevention and providing an array of services to address the care needs of this frail population
  • Only 13 percent of PACE enrollees reside in a nursing home out of the 100 percent that are eligible for a nursing home

END OF LIFE PLANNING

  • PACE makes sure that every enrollee has an end of life plan
  • An end of life plan is critically important to PACE enrollees and ensures that an individual’s preferences are known before a health crisis

EMERGENCY RESPONSE

  • PACE operates like an emergency response team in the community, responding to the needs of every enrollee during a state of emergency

FINANCIAL VALUE

  • PACE is fully capitated, assuming 100 percent risk for any costs exceeding the monthly fee paid by Medicare and Medicaid
  • The PACE program costs less to the government than the fee-for-service equivalent (FFSE), as determined by the federal and state government

CONTACT:

Candace Kuebel, Executive Director, MassPACE Association
978-580-1679
ckuebel@masspace.net
40 Court Street, 10th Floor,
Boston, MA 02108

To download and/or print this fact sheet, click here.

 

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