Abstract:

The Program of all-inclusive care for the elderly (PACE) is a long-term service delivery and financing innovation. A major goal of PACE is prevention of unecessary use of hospital and nursing home care. PACE serves enrollees in day care centres and clinics, their homes, hospitals and nursing homes. beginning in On Lok San Francisco the model has been adopted by other States and is now operational in 11 cities in 9 states. To enrol in PACE a person must be 55 or older and eligible for care in a nursing home. The PACE service delivery is comprehensive, uses an interdisciplinary team for care management and integrates primary and specialty medical care. Results of PACE have been positive. There has been steady census growth, good consumer satisfaction, reduction in use of instistutional care, controlled utilisation of medical servcies, and cost savings to public and private payers of care. However, starting up a PACE program requires substantial time and capital and the program has not yet attracted large numbers of older middle income adults. The growing number of older people in the US challenges health care providers and policy makers to provide quality health care in an environment of shrinking resources. The PACE model's comprehensiveness of health and social services, its cost-effective coordinated system of care delivery and its method of integrated financing have wide applicability and appeal.