Hospices Navigate Regulatory, Financial Concerns to Launch PACE Programs

Posted Sunday, May 9, 2021

Programs for All-Inclusive Care of the Elderly (PACE) are increasingly being started by hospices to help their clients to be able to stay home where they want to remain.

CMS reports that most PACE participants are eligible for both Medicare and Medicaid due to their significant medical and non-medical needs.

“PACE providers receive monthly Medicare and Medicaid capitated payments for each enrollee. PACE programs are also Part D providers that are responsible for their patients’ medications and pharmacy services. More than 135 PACE programs operate across roughly 31 states nationwide, serving approximately 57,000 seniors, according to Dorothy Ginsberg, senior PACE consultant for CareVention HealthCare Consulting.”

“PACE programs provide services that are needed and they may not be paid services that Medicare or Medicaid would normally pay for,” Ginsberg said. “The focus of PACE is on preventative and proactive care, trying to avoid ER visits, hospitalizations and the slow down any of that decline in chronic illness. There aren’t any benefit limitations. It’s entirely up to the interdisciplinary team to determine what services are needed and to authorize them.”

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