PACE Archives » MassPace

How PACE Supports Adults 55 and Older to Remain Safe and Independent in Their Homes

October 9, 2025/in Articles/by masspace

This article was originally published on Warner Norcross + Judd.

In the most recent Warner Medicaid Moments vlog, attorney Catherine Jacobs discusses the Program of All-Inclusive Care for the Elderly, or PACE, a Medicaid program that helps adults 55 and older meet their health care needs in the community for as long as possible instead of going to a nursing home or other care facility.

A common goal for many older adults with complex medical needs is to stay in their home with loved ones. Catherine discusses how each of the PACE offerings, including adult day centers, home health care, preventative care and transportation, are designed to help participants be independent and safe in their home. She also covers how PACE works to support both participants and their caregivers through education and support groups. Catherine breaks down all the PACE offerings and the nuances of eligibility.

Watch the video online.

PACE provider myPlace sees insurer partners as key to growth: CEO

August 5, 2025/in Articles/by masspace

This article was originally published on Modern Healthcare.

Robbie Pottharst, CEO of myPlace Health, is out to woo Medicare and Medicaid insurers to expand its Program of All-Inclusive Care for the Elderly, or PACE, business…

Read the full article here.

Study Finds Older Adults Are Spending Too Long in Emergency Departments

July 28, 2025/in Articles, In the News/by masspace

This article was originally published on The Well News.

Research by a group of Boston-area doctors suggests older adults are spending more time than they should in hospital emergency departments, substantially increasing their risk of immobility and delirium.

The study, which examined trends in older adults’ ED stays, was published in June in JAMA Internal Medicine, a publication of the Journal of the American Medical Association.

What the researchers found was a substantial increase in the proportion of adults with prolonged length of stay and boarding times over the past eight years.

Based on health records from more than 1,600 hospitals and 295 million adults aged 65 years or older, 20% of emergency department patient encounters had a length of stay of more than eight hours at the end of 2024, an 8-percentage-point increase from the start of 2017.

This is particularly noteworthy in light of past studies that have suggested that every hour spent amongst the beeping monitors and bright lights of the typical emergency department can increase an older adult’s risk of further problems, including delirium.

In fact, such is the level of concern over this that the Centers for Medicare & Medicaid Services now requires hospitals to attest they have procedures for containing emergency department length of stays to eight hours and boarding times to three hours for a percentage of older adults.

Despite the release of its “Age-Friendly Hospital Measure,” CMS recognizes that some emergency department stays may be prolonged as a result of the need for thorough medical evaluations.

However, boarding times, defined as the wait between the decision to admit and the actual admission to an inpatient bed, are determined by a number of hospital-level factors, including bed capacity.

Here, the researchers detected a 14-percentage-point increase in older adults’ boarding times exceeding three hours, rising to more than one in three visits, over the same study period.

And they said the trend toward longer stays appears to be coinciding with more emergency department visits for older adults.

In 2022, the number of visits for the top 10 diagnoses was about 33 million for people aged 65 years or older, compared with about 23 million in 2016, according to the U.S. Centers for Disease Control and Prevention.

Meanwhile, a recent study predicted the U.S. may reach the threshold for a full-blown hospital bed shortage by 2032, which would likely further lengthen emergency department boarding times.

The new study found a small decline in the rates of prolonged emergency department stays and boarding after the COVID-19 pandemic.

But the larger patterns, coupled with the aging U.S. population and workforce shortages, lead experts to believe that conditions will only get worse, the researchers said.

Emergency departments at academic hospitals had even greater increases in both length of stay and boarding times in the new study.

In these settings, the proportion of prolonged stays increased from 19% to 30%, while the share of prolonged boarding times rose from 31% to 45%.

One reason for this may be that academic hospitals often also have cancer centers or specialty surgical centers whose planned inpatient admissions reduce the number of available beds. In addition, these hospitals often provide more complex care than other health systems.

JAMA asked Dr. Maura Kennedy, MPH, division chief of geriatric emergency medicine at Massachusetts General Hospital, to comment on the study.

Among other things, she noted the cyclical nature of prolonged emergency department stays.

When hospital beds are occupied, patient boarding times are longer, which in turn increases the likelihood of delirium or mobility issues for older patients.

This ups the chances of prolonged inpatient stays, which then leads to more occupied beds, and so on, Kennedy said.

To break the cycle, she suggested emergency departments consider a number of options.

One was a hospital-at-home program model, through which clinicians could provide hospital-level care at a patient’s residence.

Another would be to leverage the CMS Program of All-Inclusive Care for the Elderly, also known as PACE, which has been associated with lower rates of hospitalizations and ED visits.

The initiative provides all-encompassing care for older adults, especially those struggling with frailty who would otherwise need to be in a long-term care facility or nursing home.

Although it’s typically only available to patients who are dual-eligible for Medicare and Medicaid, and most states have income and asset caps for the program, Kennedy suggested it could be expanded to enable more older adults to continue to live within their community and reduce their need for emergency care.

The Dual Burden of Housing and Care for Older Adults

May 20, 2025/in Reports/by masspace

This article was originally published on Joint Center for Housing Studies.

As the first baby boomers turn 80 in the coming decade, a growing number of older households will face challenges paying for both housing and the supports and services they will need to remain in their homes. In a new paper out this week, we find that after paying for housing and basic living expenses, only 24 percent of single and partner households age 75 and over had sufficient income to afford a daily paid visit from a home health aide. Affordability rates were even lower for renters, households of color, and those with functional difficulties more likely to need care services. The paper builds on analysis reported in Housing America’s Older Adults 2023 and summarized in a 2024 blog post by including both single and partner households, expanding the metros included in the study, and focusing on in-home care.

A majority of older adults will need long-term care (LTC) services at some point in their lives, such as assistance with dressing, bathing, or managing complex medication regimens. Most older adults prefer to receive such care in their own homes. Yet the cost of paid LTC services is out of reach for many households. In 2021, one daily in-home visit by a health aide at the median national rate added up to $41,000 per year. Medical insurance, including Medicare, does not cover most LTC needs, and relatively few older adults have private long-term care insurance. LTC services at home are most likely to be paid for by Medicaid Home and Community Based Support (HCBS) waiver programs, which do not operate as entitlements, vary in coverage and availability by state, and are only available to those enrolled in Medicaid. Perhaps unsurprisingly, most LTC services are provided by unpaid caregivers, and the burden on family and friends can be high.

Our analysis of multiple data sources outlined in the paper found that only one quarter of the nearly 10 million households in our sample had enough income to pay for a daily care visit on top of housing and basic costs of living. Partner households were better positioned with 43 percent able to cover a daily visit (serving both partners) compared to 19 percent of those living alone. Tenure also mattered: less than 9 percent of renters were able to afford housing, basic expenses, and daily care compared to 30 percent of owners.

We found that Black and Hispanic households were least likely to afford care, with only 14 and 11 percent respectively able to fund LTC services out of income alone, compared to 26 percent of their white counterparts. And just 19 percent of households with a resident who struggled with mobility, self-care, and/or independent living were able to afford a daily care visit, though they were far more likely to need LTC services.

While a daily paid visit was out of reach for most, slightly more than half of households could afford one visit per week, and 30 percent could afford 5 weekly visits (Figure 1). Practically, periodic paid care could provide respite to unpaid family caregivers. However, even without considering the cost of a daily LTC visit, only 63 percent of the entire sample could afford their housing and basic costs of living (Figure 1, far left column). The remainder lacked sufficient income for any LTC care services.

Read the full article online here.