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PACE Development Process

Program of All inclusive Care for the Elderly (PACE)

Successful and efficient development of a PACE programs requires access to in-depth knowledge about PACE program operations, marketing and financing. Prospective PACE providers can benefit enormously from the expertise of existing organizations that have had firsthand experience in the development and implementation of PACE. PACE Technical Assistance Centers (TACs) provide such expertise and guidance. TACs are available to assist prospective providers in building successful PACE programs, taking into consideration a broad range of general as well as program-specific factors.

Across the country, TACs provide support and guidance throughout each phase of the PACE development process.

Organizational Assessment – Decision-making

Program of All inclusive Care for the ElderlyA prospective PACE organization will need to consider a number of critical factors that will impact its decision whether or not to proceed with developing a PACE program. One of the first activities an organization will undertake as a part of this decision-making process is an in-depth assessment of whether the community and the sponsoring organization will be able to support and benefit from the development of a PACE program. PACE TACs conduct organizational and market assessments and assist with the development of a business plan and other materials for presentation to the organization’s stakeholders and governing body. St Paul Center in San Diego California is an example of successful Program of All inclusive Care for the Elderly (PACE) implementation. Learn more: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/PACE/PACE

Some of the key questions that TACs will address during the assessment process are:

  • Are there sufficient numbers of elderly in the catchment area that meet the organization’s eligibility criteria and are likely to enroll in PACE?
  • What specific external and internal competitive factors need to be considered?
  • What service components must be developed and/or adapted and what are their capital requirements?
  • What are the key initial staff positions and what are the processes and criteria used to fill them?
  • What are the initial start-up costs? Will additional capital be required, and if so, are sources of capital available?
  • At what point is financial break-even anticipated?
  • What financial rate of return can be anticipated when the program is fully operational?

Planning and Development – Enrollment

PACE senior day care centerOnce an organization has decided to proceed with PACE, TACs are available to assist with the initial planning and development of the PACE program, including the development of the PACE senior day care center, hiring and training center staff, start-up and preparation of the PACE Provider Application. TACs also provide ongoing consultation once an organization is fully operational and has begun providing services to participants. TACs provide support through telephone consultation, on-site visits, intensive trainings and resource materials. Find out more here https://www.medicaid.gov/medicaid/long-term-services-supports/program-all-inclusive-care-elderly/index.html

TAC resources and services include:

  • Core Resource Set for PACE (CRSP) – set of operating practice resources for developing organizations.
  • Assistance with preparation of PACE Provider Application.
  • Assistance with facility development -PACE center design, capacity assumptions, equipment needs, etc.
  • Assistance with development of program policy and procedures.
  • Assistance with development of efficient management structure – key staff roles, job descriptions, etc.
  • Service integration training – interdisciplinary team training, service allocation and care planning.
  • Consultation on marketing and census building.
  • Consultation on development of QI program and implementation of QI plan.
  • Assistance with establishment of financial reporting and monitoring systems.
  • Consultation on data collection systems and data collection training.
  • Onsite review of ongoing operations and recommendations regarding potential improvements.