older Black couple relaxing on a porch
Get ready for takeoff
by Orsula V. Knowlton

The COVID-19 pandemic will have long-lasting effects on the American health care system. The industry has already seen accelerated investment in and adoption of digital health care solutions such as telehealth programs and remote patient monitoring services. And while the totality of the pandemic’s effects is still unknown, one story stands out: the agility of Programs of All-Inclusive Care for the Elderly (PACE).

PACE delivers medical and social services to eligible individuals, which include those 55 and above who live in an organization’s service area and meet its need requirements, who need nursing home-level care and who can live in the community with assistance from PACE. In CareVention’s work with PACE organizations, which includes personalized medication safety and pharmacy services, electronic health record technology solutions, risk adjustment and third-party administration, company leaders became aware of the agility of PACE operators during the pandemic. These organizations updated services with measures such as the expanded use of telehealth, mobile health vans, social support services and more to serve the evolving needs of individuals under their care.

This agility supported PACE in bolstering a desirable path of care for many adults, providing the opportunity to stay safer from COVID-19 while remaining in a comfortable, familiar environment. The continued ability to serve participants in their homes became a key advantage as traditional skilled nursing facilities experienced virus outbreaks and related deaths.

Continuing the Move Toward Aging at Home

It’s no secret that many people want to age at home. It’s often where they feel most comfortable and where they can best thrive. According to the AARP 2021 Home and Community Preferences Survey, 77% of adults ages 50 and up want to stay in their homes for the long term; this statistic has remained stable for more than 10 years.

The persistent lean toward aging at home aligns directly with the PACE model. PACE offers home- and community-based services, including homecare, nutritional counseling, occupational therapy and dentistry, among others, to make aging at home a reality for many individuals.

Expanding the Participant Pool

The number of people in the U.S. 65 and older exceeded 54 million in 2019, and this number is expected to hit 80.8 million by 2040 and 94.7 million by 2060. The average PACE participant is 77 years old. Thus, the growth of the 65-and-older community could support expanded PACE enrollment, which has increased from about 55,000 participants in 2020 to about 60,000 participants at the beginning of 2022.

The PACE model dates back to the early 1970s and has expanded greatly since then. In 1999, there were just 30 programs. In 2014, there were 106 programs, and now there are more than 140.

While PACE has experienced substantial growth, there’s still room for more. According to the National PACE Association, more than 885,000 adults who are potentially eligible for PACE and live in states where it operates lack access to a program. This represents a massive untapped pool of adults who could benefit from the services offered through PACE.

In April 2021, Sen. Bob Casey of Pennsylvania, who is chairman of the U.S. Senate Special Committee on Aging, introduced the PACE Plus Act with the objective of improving access to the program. If passed, the bill would support PACE expansion through grants, enhance access to programs and their affordability for certain Medicare beneficiaries, and bring about updates regarding site approval and expansion, among other measures.

The Bottom Line

Having helped to stand up and support many PACE organizations, there is great potential in the future of PACE—especially given the agility that PACE organizations have demonstrated in providing the elderly population with critical care services during one of the most trying times in American medical history.

It’s clear that many seniors want to be home, where they’re comfortable and feel safe, and PACE makes it possible for participants to receive quality care without having to move into a facility. The opportunity to expand enrollment and the PACE Plus Act underscore the potential for PACE to thrive. As a result, PACE will likely be an even more critical component of senior care in 2022 and beyond.

Orsula V. Knowlton, Pharm.D., MBA, is cofounder and president of Tabula Rasa HealthCare (TRHC), a health care technology company advancing the safe use of medications. TRHC’s CareVention HealthCare division partners with value-based health care organizations such as PACE with service lines like CareKinesis, the first national PACE-centric medication management and distribution pharmacy that focuses on reducing medication-related risk while enhancing economic, clinical and humanistic outcomes. Visit tabularasahealthcare.com.