Long-Term Care in the United States- The PACE Program

The following post was written by guest blogger, Carly Lee.
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Many people in the U.S. will require some form of long-term care (LTC). Over the decades the population has been continuously increasing mainly due to Americans living longer. More services are required to care for the aging population. Twenty-five percent of individuals, most over the age of 85, will need extensive care that deals with cognitive and functional conditions (Hokenstad, 2005). Many elderly Americans have expressed wanting to retain their independence while still receiving medical treatment and help with activities of daily living.

In Chapter 8, different types of long term care (LTC) are described. The most well-known being nursing homes and assisted-living facilities. In the past, LTC was typically provided at a nursing home but due to the skyrocketing costs, families can end up spending their life savings on these facilities. An article from the New York Times states that “the nursing home model is no longer financially viable or medically justified” (Berger, 2012).

There is an innovative program that provides comprehensive healthcare for the elderly called PACE, Program of All-Inclusive Care for the Elderly. With PACE, the patient has an interdisciplinary team that includes doctors, social workers, nurses, and many other services while continuing to live at home. The program exists is 29 states today and is paid for primarily by Medicare and Medicaid with no deductibles, co-insurance, or copayments (Berger, 2012). PACE care supervisors are focused on preventative care in order to avoid patients being hospitalized or going to a nursing home. Family participation is also strongly encouraged.

According to the Medicaid website (, individuals must meet four main eligibility requirements. First, the individual must be 55 years of age or older and able to life in their home and environment safely. In addition they must live in an area where the PACE program is provided. Lastly, the individual has to be eligible for nursing home care as well.

The services make this program extremely efficient in maintaining and improving one’s health. Recipients receive care that is flexible and can accommodate their lifestyles. For example, not only does the program provide transportation for medical appointments, but the driver also assists the participant to and from the vehicle if needed. This service takes a good amount of pressure off of family care givers who have to rearrange their own lives and schedules to assist loved ones. For medications, the program covers all Medicare Part D prescriptions. Participation in the program is completely voluntary and participants can opt out any time. The downside is that the consumer most use a doctor that is in-network with the program.

PACE promotes preventative care by offering activities that encourage nutrition and socialization. Berger briefly describes CentreLight Healthcare, the largest PACE program in the nation, located in New York. CentreLight has day centers which provide nutritious meals, activities, and an opportunity to make new friends. Recently Northern Virginia established the first PACE program in that area, InovaCares for Seniors. With more program locations available along with the rising costs of nursing homes, physicians, family members and Elder Law attorneys are promoting PACE to clients.

Despite recent improvement in the quality of nursing homes care, alternatives choices are becoming increasingly popular (Hokenstad, 2005). Sultz and Young (2011) frequently point out that the health system needs to be continuous, organized, and integrated in order to provide the most beneficial care.

About the author:
Carly Lee is a student at Towson University who wrote this article as part of her class on “Health Care in the U.S.”

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.