Category: Medicare


Why Consider PACE Program for the Future

Why PACE program of all inclusive care for the elderly

Why PACE: program of all inclusive care for the elderly

Programs of All-inclusive Care for the Elderly (PACE) serve seniors with chronic care needs by providing access to the full continuum of preventive, primary, acute, and long term care services. PACE Programs California take many familiar elements of our traditional health care system and reorganize them in a way that makes sense to families, health care providers and the government programs and others that pay for care.

PACEFor consumers, PACE provides:

  • Caregivers who listen to and can respond to their individualized care needs
  • The option to continue living in the community as long as possible
  • One-stop shopping for all health care services

For health care providers, PACE provides:

  • Capitated funding arrangement rewards providers that are flexible and creative in providing the best care possible
  • Ability to coordinate care for the individuals across settings and medical disciplines
  • Meets increasing consumer demands for individualized care and supportive services arrangements

For those who pay for care, PACE provides:

  • Cost savings and predictable expenditures
  • Comprehensive service package emphasizing preventive care that is usually less expensive and more effective than acute care
  • A model of choice for older individuals focused on keeping them at home and out of institutional settings

What is PACE and how is PACE Paid for?

Medicare PACE ProgramWhat is PACE? PACE is a fully capitated program in which the Centers for Medicare PACE Program and Medicaid Services (CMS) pays the Medicare capitation, and each State establishes and pays the Medicaid capitation. These capitated payments are combined at the provider level, creating a flexible funding pool for all primary, acute and long term care services.

The goal of rate setting for PACE is to establish capitation rates that are acceptable to both providers and payers. In general, the Medicare capitation payment is about one-third of the payment PACE providers receive for each enrollee.

Why Consider PACE for the Future

  • PACE provides a full range of preventive, primary, acute and long term care services that enable frail older individuals to live in the community as independently as possible
  • PACE provides care and services consistent with emerging consumer demands for individual choices in health care and services
  • PACE combines adult day settings, home care, interdisciplinary teams, transportation systems and capitated payment systems so that providers can respond to the unique needs of each frail elderly individual served
  • Twenty-six providers have successfully replicated the PACE model, demonstrating the value of high quality, individualized care PACE provides for its participants. Eleven other providers are operational and on their way to developing PACE programs

 

Funding Options on How to Choose a Certified Aging in Place Specialist

Funding Options on How to Choose a Certified Aging in Place Specialist

How to Choose a Certified Aging in Place Specialist

Let’s talk about how to choose a Certified Aging in Place Specialist. Also, let’s talk about some financing options for aging in place modifications. In general, there are two types of funding to pay for modeling of your parents’ home, private and public. The most likely source of private funds are their own. Perhaps they have enough savings to cover the renovations or a home equity loan might be a good source of funds, especially if they have sufficient income to cover monthly payments verses just taking out all of the cash from their savings.

Medicaid HomeAnother option is a reverse mortgage which could also free up funds to pay for other services such as in home senior care. It’s best to check with your parents’ Financial Advisor before making a determination on which of these options might be best for them. Sometimes home modifications can be prescribed by your parents’ doctor. If that’s the case, get the prescription in writing and your parents may be able to claim a medical deduction on their federal Income Tax return.

On the same note, check with your parents’ private health insurance company to see if they will pay for the modification. Show them the prescription from the Doctor or Physical Therapist. If the insurance company says no, getting a written letter of denial is suggested. Other private funding options include contributions, donations and in-kind work from family members, community service groups, churches or other non-profit organizations. Be sure to check with your parents’ local Senior Center or Council on Aging for possible referrals.
The other funding option is public sources which are normally income and needs based. Funds may be available for home modification under the Medicaid Home and Community Based Services Waiver. Another option is to call your local Social Security office to see if any of the equipment your parents need might be covered under PACE Medicare, or if either of your parents is a veteran, contact the local VA to see if funding is available through that agency.

Medicare PlansMany states and communities also offer home modification programs to help some homeowners pay for necessary changes. Local community development or social services agencies usually administer these programs, so contact your parents’ town or city hall for information. Some of these community programs have carpenters, plumbers, electricians and painters on staff to do the work.

Other programs furnish free labor and the homeowner purchases the necessary material. Low interest or no interest loans, usually not repayable until the homeowner sells or leaves the home are offered by other programs. Some programs simply provide a list of reliable contractors and assist in the process of receiving bids, selecting the contractor, developing a contract and ensuring that the work is performed in accordance with the contract.

As you can see there are certainly a lot of options out there, it’s wise to help your parents do their homework before committing to any aging in pace or other home improvement project. Doing so could save your parents’ valuable dollars all while making their house a place where they’ll be able to call home for a lifetime.