Catch Up Day 22- Medicaid at 50: PACE!

You may or may not have heard about the program known as PACE (Program of All-inclusive Care for the Elderly) before. This is a program that provides wrap around services to people over the age of 55 across the United States. It provides community based social services and medical services for people living in the home and community who meet an institutional level of care need. It’s an alternative to nursing facility care.

Ready for some fun health policy jargon? It’s a capitated Medicaid state plan option available in 114 locations in 32 states serving 22,000 beneficiaries jointly run by Medicare and Medicaid using Medicare demonstration authority. Medicaid pays the cost sharing for eligible individuals but Medicaid eligibility is not a requirement for participation.

Phew, ok. Back to the fun story.

Take yourself to Chinatown in San Francisco in the early 1970s. Feel the Peace and Love? Great.

On Lok Senior Health Services started an adult home care service in 1973 in the city of San Francisco serving seniors using a British hospital system model. The primary beneficiaries were recent immigrants from Italy, China, and the Philippines. Within 7 years the organization got waivers to provide medical care and be reimbursed by Medicare. By the mid-1980s the program got the attention of Congress and it quickly became part of Medicare and Medicaid law. The number of PACE sites has tripled in the last 8 years. It’s likely because integrating social services is not only popular, it often has better health outcomes. For this vulnerable population, social service integration is necessary to keep people happy and healthy in their homes.


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