What is PACE?

The Program for All-Inclusive Care for the Elderly (PACE) provides comprehensive medical and social services to certain older adult participants living in the community. The program provides all needed health care, medical care, and ancillary services across all settings. Services include primary and specialty care, adult day health services, personal care services, inpatient hospital care, prescription drugs, occupational/physical therapies, and nursing home care, offered through an interdisciplinary team responsible for coordination of 24-hour care delivery. This hands-on approach also assists in preventing abuse and enhancing social supports. The vast majority of those served by PACE are dually eligible for both Medicare and Medicaid.

Ohio’s current PACE program is in Cleveland and offers 3 sites across Cuyahoga County, managed by McGregor PACE. PACE is in the process of expanding to Franklin, Hamilton, Montgomery, Lorain, Lucas, Summit, Trumbull, Ashtabula, and Mahoning counties.  In Ohio, PACE receives full capitation from both Medicare and Medicaid. They have an inter- disciplinary team that directs and provides the care of their participants. The site pools its resources to pay for whatever services an individual needs, including services not otherwise covered by Medicare or Medicaid. This flexibility enables them to be proactive in their care of participants.

To be eligible for PACE, participants must be age 55 or older and live in an area with a PACE site. Participants can also pay for their own services. If you are unable to pay for PACE services, you may qualify for Medicaid assistance. To get Medicaid assistance with paying for PACE, you must also qualify for coverage under the institutional financial eligibility standards. To determine if you may be eligible for Medicaid, visit Ohio Benefits.

PACE participants also must need an intermediate or skilled level of care and be willing to receive all of their care from PACE program providers. In addition, participants must be able to remain safely in a community setting at the time of initial enrollment.