PACE: Program of today or tommorrow?

In 1997 former President Bill Clinton signed Public Law 105-33 which created the greatest change in Medicare and Medicaid since its creation in 1965. This created PACE to be a permanent provider type under Medicare, and states were granted the option of paying a capitation rate for PACE services under Medicaid. The incentive to this program is that it provides less cost than the traditional Medicaid and Medicare programs and it allows people that might have to go into a nursing home an additional option. This program even allows care to be given in the house for the patients. This program is one of the better offers for long-term care that the elderly can choose.

1. Provide a basic description of PACE. How did it get started? What is its goal? Whom does it serve? How is a typical PACE program organized? What types of services does it offer? ETC.

In the Balanced Budget Act of 1997, PACE became a permanent provider type under Medicare, and states were granted the option of paying a capitation rate for PACE services under Medicaid. PACE or Program of All-inclusive Care for the Elderly is a program that has been developed as a alternative to long-term services offered by Medicare and Medicaid. The PACE prog

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Under the Medicare program, the monthly capitation rate paid by CMS to the PACE provider equals the Adjusted Per Capita Cost (AAPCC) as calculated by CMS for HMO reimbursement with adjustment for frailty factors. About half of the expenditures for preventable medical errors are for direct health care costs (Medication). The rates are considered payment in full (Eng). The risk is that PACE consumes full responsibility of all medical treatment for a patient. If it shows that it can prevent costs in the long run, then the government will support and finance it. Another function of managers is with mental health patients. Another provider of home health care and management is long-term care insurance. With PACE’s reliance on an adult day services model, would the dispersion of the population present a problem? Where would be a good spot to locate PACE given its target population?

The dispersion of the population should not really affect or present any problems. Starting up a PACE program requires substantial time and a lot of capital. Kansas City has geographically dispersed population. On Lok documented to HCFA that the cost of care for their members was 15% less than that for fee for service Medicare enrollees (HCFA). The value of home health care has developed over the years with the patient in mind. The ideal situation would be to have a sponsor that would involve a hospital/health care system, like in the Sutter Senior Care in Sacramento, CA.

Approximate Word count = 2898
Approximate Pages = 12 (250 words per page double spaced)

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