Next Steps for PACE Pilots

Members | March 24, 2017 | by Peter Notarstefano

The Centers for Medicare and Medicaid Services posted the comments they received from stakeholders concerning the Request for Information (RFI) on the application of PACE-like models for additional populations, including populations under the age of 55 and those who do not qualify for a nursing home level of care.

The Centers for Medicare and Medicaid Services posted the comments they received from stakeholders concerning the Request for Information (RFI) on the application of PACE-like models for additional populations, including populations under the age of 55 and those who do not qualify for a nursing home level of care.  Medicaid agencies from ten states submitted comments: Louisiana, Michigan, New York, Pennsylvania, Virginia, Washington, Tennessee, New Mexico, Nevada and Florida. LeadingAge submitted comments on the PIA RFI along with LeadingAge NY that were also included in the file of comment letters. Both Aging Services groups and Advocacy groups that represent persons with disabilities submitted useful comments. Comments were also submitted by Managed Care Organizations. 

The PACE Innovation Act of 2015 (PIA) authorized to test application of PACE-like models for additional populations, including populations under the age of 55 and those who do not qualify for a nursing home level of care, under Section 1115A of the Social Security Act. In order to inform possible development of a model test under the PACE Innovation Act, CMS released a Request for Information (RFI) on Dec. 23, 2016.

This RFI has 2 parts:

  • CMS seeks comment on potential elements of a 5-year PACE-like model test for individuals dually eligible for Medicare and Medicaid, age 21 and older, with disabilities that impair their mobility and who are assessed as requiring a nursing home level of care and meet other eligibility criteria. CMS is calling this model “Person Centered Community Care” or P3C. This potential model is designed to meet the requirements of a model test under Section 1115A of the Social Security Act and to adapt the PACE model of care for one population of focus. CMS also seeks comment on the types of technical assistance that potential P3C organizations and states would require to participate in the model test.
  • CMS are seeking information on additional specific populations whose health outcomes could benefit from enrollment in PACE-like models, and how the PACE model of care could be adapted to better serve the needs of these populations and the currently eligible population.

CMS expects to make additional data on potential payment rates for the demonstration available later this spring.