PACE Programs can now be run by for-profit organizations

A May report to Congress provides the foundation for for-profit organizations to run PACE Programs. The US Department of Health & Human Services report titled “Report to Congress: The Centers for Medicare & Medicaid Services’ Evaluation of For-Profit PACE Programs under Section 4804(b) of the Balanced Budget Act of 1997” reviews a sample of non-profit and for-profit PACE programs to provide an analysis of the care provided by both types of organizations.

PACE (Program for All-inclusive Care for the Elderly) is a program that allows people who would generally require the care provided by a more institutional setting such as a nursing home to remain in the community by providing health care and support services. The Social Security Act required that PACE organizations be non-profit, but the Balanced Budget Act provided the ability to waive this requirement if certain conditions were met. In order to see if the requirements were met, this report was issued.

Overall, there were not significant differences found in the types of care that were accessible to participants or the quality of care provided in either type of organizations. Perhaps the most promising part of this report is that approximately 90% of both sets of participants reported high/very high satisfaction in the following areas:

  • Overall care
  • Information from MDs
  • Information on meds
  • Coordination
  • Transportation help when needed
  • Respect
  • How participants were viewed as people
  • Specialist care

The pilot for the for-profit PACE organizations showed that it can be as effective as non-profit organization programs, and met the requirements of the Balanced Budget Act that were needed to allow PACE programs to be run by either type of organizations.

Learn more about PACE on the CMS website.

View the May 19, 2015 Report to Congress on PACE programs.

 


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