#United States #Sacramento #Senior Care #PACE Program #Taxpayer Savings

New Insights from PRI's Report on PACE Program

A recent report from the Center for Medical Economics and Innovation at the Pacific Research Institute (PRI) emphasizes the potential benefits of reforming the Program of All-Inclusive Care for the Elderly (PACE). This Medicare and Medicaid joint initiative focuses on providing extensive medical and social services to low-income seniors, particularly those who may otherwise need to live in nursing homes. Notably, the report suggests that reforms could expand the program's reach, resulting in significant savings for taxpayers and improved care for seniors.

Economic Impact of PACE

According to the report, expanding the PACE program has the potential to yield impressive financial results. Currently, the PACE model saves an average of $2,800 per participant each month, translating into an annual total savings of roughly $33,600. Given that there are about 84,000 participants enrolled in the program, the total savings could exceed $2.8 billion annually. Dr. Wayne Winegarden, director at PRI and the report's author, emphasizes that these are not just theoretical savings; they are measurable benefits that positively affect both Medicare and Medicaid while allowing patients the dignity of receiving care in their own homes.

Growth Through For-Profit Participation

The report credits a significant growth in the PACE program to its 2015 expansion that opened the door for for-profit providers to participate. Research indicates that for-profit entities have surpassed nonprofit organizations in terms of both contract and enrollment growth, primarily due to their enhanced access to capital. This capital is essential for launching new PACE centers, which typically require investments ranging from $5 million to $10 million. Such centers are pivotal in addressing the growing needs of this vulnerable population.

Data from reputable sources, including the Journal of the American Geriatric Society, highlights that individuals enrolled in PACE exhibit lower hospitalization rates and reduced readmission events. Furthermore, a study by the Commonwealth Fund praises the program for lowering long-term nursing facility placements and mortality rates while improving the health status and overall quality of life for its participants.

Quality Assurance in Care Services

Concerns regarding the quality of service between for-profit and nonprofit PACE centers have also been addressed in the report. Findings reveal no statistically significant differences in the outcomes of care, thus establishing that for-profit participation does not compromise service quality.

In order to fully harness the potential of PACE, the report outlines several critical reforms:

• - Maintain the 2015 Expansion: Allowing for-profit providers to continue participating in PACE will help sustain the necessary capital to establish new centers.
• - Streamline Federal Regulations: Reducing delays in new program applications could minimize costs for providers, making it easier to initiate services rapidly.
• - Broaden Eligibility Criteria: Expanding the criteria to include high-need, high-cost seniors who currently do not meet narrow Medicaid standards could offer much-needed assistance to more individuals.

Conclusion

Dr. Winegarden concludes that for-profit providers are essential for extending PACE's benefits to a larger population of seniors. By targeting underserved communities and meeting the significant upfront investments required to establish new centers, these providers do not compromise on the quality of care. Shifting focus to PACE could be a vital component of broader reforms aimed at saving taxpayer dollars while delivering superior care.

The PRI's Center for Medical Economics and Innovation strives to inform policymakers, healthcare professionals, and the public about the critical impact of healthcare advancements and economic growth strategies. For those interested in this enlightening study, download the brief from the Pacific Research Institute's website.