CMS Proposes Updates to PACE Program

WASHINGTON, D.C. (August 12, 2016)—Since becoming acting administrator, I have spoken frequently about to the importance of moving to the next chapter in implementing the Affordable Care Act. This new chapter goes beyond providing people with quality, affordable coverage—but making sure that we are delivering patient-centered care to all consumers at critical stages of their lives.

What does that look like? It looks like more individualized care—care that allows people to heal, recover and age in their homes and communities; care that is coordinated so we avoid people falling through the cracks; and care that includes family members and the realities of all the things that impact our health like culture, nutrition and other social factors. For the growing number of aging and frail Americans, many living with Alzheimer’s, it looks like PACE.

The Programs of All-inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program that helps people meet their health care needs in the community in which they live instead of a nursing home or other care facility. The focus is on the participant. A team of health care professionals works to make sure that care is coordinated in the home, the community and at a PACE center.

Today, CMS proposed the first major update to the PACE program in a decade. This proposal will help the program reflect the latest advances in caring for frail elders and changes in the use of technology. The goal of this proposal is to strengthen beneficiary protections and provide PACE organizations with more administrative and operational flexibilities so they can do what they do best—caring for our nation’s most vulnerable individuals. While PACE serves a relatively small number of people today, our proposal is intended to encourage states to further expand these programs.

Our proposals aim to offer the kind of common sense supports to allow older adults to get the best care possible. For example, individual care team members would be able to serve more than one role in addressing the wide spectrum of a participant’s needs, rather than just the one role they are permitted to occupy today. This would help better coordinate services, while providing important flexibility to care providers.

We also propose more modern and simplified administrative and operational rules to enhance PACE organizations’ ability to do a number of things more easily, including a more automated application process to speed up and customize services to participants.

Over the last six years, since the onset of the Affordable Care Act, we have been taking significant steps to care for more people, care for them better, and make health care more affordable. But for us to be successful, we need to work hand-in-hand with patients and their families, physicians and clinicians and other actors to support new approaches to care. Team-based models that put the individual in the center, such as PACE, will be a vital part of the fabric of our system.

We must work hard to support these approaches so our country can continue to provide our people with the care they need in the years ahead.

Learn more about the proposed rule to update and modernize PACE here.

Visit medicare.gov for more information.

—Andy Slavitt