Improving access to and enrollment in Programs of All-Inclusive Care for the Elderly (PACE)
- Collection:
- Health Policy and Services Research
- Contributor(s):
- Bipartisan Policy Center, issuing body.
- Publication:
- Washington, DC : Bipartisan Policy Center, October 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Services Accessibility Health Services for the Aged -- organization & administration Government Programs -- organization & administration United States
- Genre(s):
- Technical Report
- Abstract:
- For the last decade, the Bipartisan Policy Center’s Health Program has advanced federal policy reforms to improve chronic and long-term care for individuals with complex needs. This work began with four of BPC’s health leaders--former Senate Majority Leaders Tom Daschle and Bill Frist, former Health and Human Services Secretary and Gov. Tommy Thompson, and former Congressional Budget Office Director Alice Rivlin. BPC has since released reports that include a range of bipartisan, federal policy solutions to improve access to long-term services and supports (LTSS); simplify and streamline authorities for Medicaid home and community-based services (HCBS); and better integrate care for individuals dually eligible for Medicare and Medicaid. Building on those efforts, BPC seeks to improve access to and enrollment in Programs of All-Inclusive Care for the Elderly (PACE). PACE is a fully integrated, comprehensive care model available to qualifying beneficiaries through Medicare, Medicaid, and private payments (by individuals without Medicare or Medicaid.) The provider-led, home and community-based care model generally centers around an adult day care center and is available to frail, older adults (ages 55 years and older). Access to community-based, high-value, fully integrated care models such as PACE is increasingly important as the U.S. population ages rapidly and demand for LTSS grows. Improving the spread and scale of PACE would help address expected, growing demand for LTSS by providing eligible, older adults with access to comprehensive care in their homes and communities. Through interviews with key stakeholders and a private roundtable discussion, BPC identified several challenges to the growth of PACE that policymakers and the Centers for Medicare & Medicaid Services (CMS) should address through legislative, regulatory, and policy reforms. These challenges include reducing administrative barriers to the submission and review of applications for new PACE programs and service area expansions (SAEs); high Part D premiums that make PACE unaffordable for Medicare beneficiaries who are ineligible for Medicaid; limits on eligibility that make PACE unavailable to certain high need, high-cost (HNHC) populations who are likely to benefit from the model; strict federal rules around marketing PACE programs; lack of clear, easily accessible consumer information on PACE; quality and encounter data that do not adequately capture the full range of services delivered by PACE models and the value of PACE; and inadequate resources at the state and federal levels to support the appropriate growth of PACE. This report contains new federal policy recommendations that would address the challenges to the spread and scale of PACE. As described in the Policy Landscape section below, both political parties have introduced legislation that aims to make PACE more affordable and accessible to current and new populations. Throughout this report, BPC describes how our recommendations align with or differ from any proposed legislation.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (70 pages)) : illustrations
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918557286406676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918557286406676