Program of All‐inclusive Care for the Elderly (PACE): An Innovative Model of Integrated Geriatric Care and Financing

Abstract

The growing number of older people in the United States challenges healthcare providers and policy makers alike to provide high quality care in an environment of shrinking resources. The PACE model's comprehensiveness of health and social services, its cost-effective coordinated system of care delivery, and its method of integrated financing have wide applicability and appeal.

“Knowing is Better”: Preferences of Diverse Older Adults for Discussing Prognosis

“…On Lok patients are nursing home eligible and live an average of 4.5 years from the time of their enrollment. 31 With its interdisciplinary model of community-based long-term care, On Lok aims to help seniors live at home and in their familiar communities for as long as possible. Though each On Lok center serves a diverse patient base, some centers focus on providing services to specific groups such as Latino or Chinese elders.…”

A Pilot Test of the Effect of Guided Care on the Quality of Primary Care Experiences for Multimorbid Older Adults

“…[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] However, each of these innovations addresses only a subset of the challenges faced by older chronically ill people and rarely have more than 2 of these innovations been combined in practice. 21,22 To improve quality of life for older adults with multimorbidity and complex care needs and to promote the efficient use of resources, we designed Guided Care (GC)-an enhancement to primary care that addresses all components of the Chronic Care Model, including access to community resources and policies, self management support, delivery system redesign, clinical information systems, decision support, a prepared and proactive practice team, and an informed and empowered patient and family. 23,24 In GC, a registered nurse who has completed a supplemental curriculum works in a practice with several primary care physicians (PCPs) to provide cost-effective chronic care to 50-60 multimorbid patients.…”

The After Discharge Care Management of Low Income Frail Elderly (AD-LIFE) Randomized Trial: Theoretical Framework and Study Design

“…AD-LIFE is more of a ''consult and support'' model in which patients keep their own PCP rather than switching to a closed staff model or clinic as is done in the PACE model and other programs. 11,12 Our model may have greater appeal to patients and providers and may be more generalizable across the country where the majority of care is delivered in the community setting in the patient-physician dyad model.…”

“…[5][6][7][8][9][10] Numerous care management programs for frail elders have been reported; however, few have been tested using randomized trials. [11][12][13] In addition, models described in the literature vary substantially in scope (ie, social vs medical models). 11 As a result, no single model has emerged that is convincingly superior.…”