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Home-based care providers could see a substantial runway for expansion under a bipartisan bill that would mandate every state to offer the Program of All-Inclusive Care for the Elderly (PACE) while easing barriers to opening new sites.
The PACE Access Improvement Act attempts to change PACE enrollment restrictions and make PACE mandatory under Medicaid. The bill is a step toward improving care for older adults, industry leaders told Home Health Care News.
“Allowing seniors to enroll when they need care, rather than waiting until the beginning of the following month, removing unnecessary barriers to opening and expanding centers and making PACE available in every state would meaningfully improve access,” InnovAge CEO Patrick Blair told HHCN.
Denver-based InnovAge offers PACE services for eligible older adults in California, Colorado, Florida, New Mexico, Pennsylvania and Virginia.
U.S. Reps. Debbie Dingell, D-Mich., and John Moolenaar, R-Mich., introduced the PACE Access Improvement Act on Sept. 24. The bill aims to augment PACE, a joint Medicare and Medicaid program that allows older adults to receive nursing home-level care at home through coordinated support and care services.
Individuals can enroll in PACE if they are 55 or older, live within the service area of a PACE organization, have state certification that they require nursing home-level care, and are able to live safely within the community with the help of PACE services at the time of enrollment.
While PACE is one of the most comprehensive and effective care models for older adults with complex medical and social needs, Blair said it reaches only a small fraction of those who could benefit.
Currently, individuals can enroll in PACE at any time of the month, but coverage does not take effect until the first day of the month after the PACE organization receives the signed enrollment agreement.
The PACE Access Improvement Act aims to change that. The bill would still allow eligible individuals to enroll in PACE at any time during the month, but their coverage would go into effect the day the provider signs the paperwork. This means older adults can get coverage sooner upon sign-up.
The bill would also make PACE mandatory under Medicaid, which would require all states to have PACE programs. Currently, 33 states offer PACE programs.
PACE progress
The PACE Access Improvement Act is a step in the right direction toward improving PACE access, said Blair.
PACE serves only a small fraction of the older adults who could benefit from it and the bill could help expand the program’s reach, he said.
“The PACE Access Improvement Act represents an important step toward closing that gap,” Blair said. “Earlier intervention through coordinated, preventive care could help more seniors maintain their independence and potentially avoid more costly care settings.”
U.S. Sen. Mark Warner (D-VA) is expected to introduce a Senate companion for the PACE Access Improvement Act in November, according to one of the bill’s supporters, the National PACE Association.
For Michigan PACE providers, one anticipated change from the bill is the ability to introduce PACE services to communities before a new center opens. Centers can have staff, buses and drivers ready before they can begin promoting their services, according to Stephanie Winslow, executive director of the PACE Association of Michigan.
“We can’t do a lot of marketing to folks prior to opening our centers,” Winslow said.
The PACE Association of Michigan, based in Lansing, Michigan, is a nonprofit organization dedicated to expanding PACE services, programs and education throughout the state.
Allowing earlier outreach would give prospective PACE participants time to learn about the program and explore open enrollment before a center opens, according to Winslow.
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