The PACE Model
PACE - Program of All-Inclusive Care for the Elderly - is a comprehensive, holistic, managed-care program. The goal of PACE is to assist frail seniors, who can safely live at home upon program entry, continue to live at home as long as possible.
When you become a PACE participant, all your medically-related expenses are covered by the program. The care you receive is based around attendance at the Bluestem PACE day center. While participants engage in social activities at the center, they also have access to primary care, physical therapy, hot meals and other services.
Why should I become a PACE participant?
1. All your medical care is covered and organized for you.
PACE organizations provide an entire range of medical care, long-term services and support needed by older adults. These include primary and specialty medical care; in-home services; prescription drugs; specialty care such as audiology, dentistry, optometry, podiatry and speech therapy; respite care; transportation; adult day services, including nursing, meals, nutritional counseling, social work, personal care, and physical, occupational and recreational therapies; and hospital and nursing home care, when necessary.
In short, PACE covers all Medicare Part A, B and D benefits, all Medicaid-covered benefits, and any additional services that are necessary to maintain or improve the health status of participants.
2. Care will be provided to you in multiple settings.
Once you are a PACE participant, you’ll receive comprehensive health and supportive services in a range of settings. At the PACE center you’ll receive primary care, therapy, meals, recreation, socialization and personal care. In your home PACE offers skilled care, personal care supportive services, and supports such as ramps, grab bars, and other tools that ensure you are safe in your home. In the community, PACE offers access to specialists and other providers.
3. PACE is both a health provider and a health plan.
PACE combines the concentration and personal touch of a provider with the management and efficiency of a health plan. Our team of experts will monitor your health and respond rapidly with any necessary changes. The PACE team is also responsible for managing and paying for services delivered by contracted providers such as hospitals, nursing homes, and specialists so you don’t have to worry a thing!
How is PACE paid for?
PACE organizations receive fixed monthly payments from Medicare, Medicaid and private payers (for program participants who are not dually eligible). These funds are pooled, and care is provided following a comprehensive assessment of a participant's needs. This bundled payment provides a strong incentive to avoid duplicative or unnecessary services and encourages the use of appropriate community-based alternatives to hospital and nursing home care.
Who does PACE serve?
PACE serves more than 35,000 participants in 32 states. PACE serves individuals who are age 55 or over and certified by their state as needing a nursing home level of care. The average participant is 76 years old and has multiple, complex medical conditions, cognitive and/or functional impairments, and significant health and long-term care needs. Approximately 90 percent are dually eligible for Medicare and Medicaid. PACE participants must live in a PACE service area and be able to live safely in the community with PACE services at the time of enrollment.
Still have questions?
If you have additional questions, you can contact Bluestem PACE by calling 844-588-7223 or (for hearing impaired) 800-766-3777 or filling out our request information form.