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An advisory committee is urging the Department of Health and Human Services to expand the Program of All Inclusive Care for the Elderly (PACE). 

The National Advisory Committee on Rural Health and Human Services offered a variety of recommendations to HHS in a recent report, including a PACE pilot for Medicare-only beneficiaries in rural areas. Currently, only dual-eligible Medicare and Medicaid enrollees can participate in the program, which provides both home-based and facility-based services for people 55 and older. 

The advisory committee recommended a number of other initiatives, including extending telehealth coverage to PACE programs, a resource guide to promote PACE to rural and tribal communities, loan repayments under National Health Service Corps and the Nurse Corps, and an expedited approval process for existing programs that want to expand service to other areas. 

The National PACE Association applauded the recommendations and urged HHS and Congress to adopt them.

“These recommendations are desperately needed and will go a long way toward ensuring that residents in rural America have access to PACE, which is a proven way to ensure that elderly Americans can remain independent in their own homes and avoid nursing home care,” National PACE Association President Shawn Bloom said in a statement. 

The report stemmed from a meeting the National Advisory Committee on Rural Health and Human Services convened in Kansas last fall to examine the use of PACE in rural communities. In the report, the committee said it was impressed with how the program addresses social determinants of health by accessing high-quality medical care, as well as patient access to socialization, community services and safe housing. However, the committee also noted barriers to growing the program, including a lack of awareness of PACE and the high cost to launch the program. 

“The significant start-up funding and application process needed to establish PACE organizations are barriers to initial implementation as well as expansion,” the committee stated in the report. “PACE organizations that successfully serve rural populations maximize existing partnerships and resources, but the Committee realizes that may not be feasible in under-resourced rural communities.” 

PACE is currently offered in 31 states with roughly 60,000 enrollees. The program provides frail seniors who qualify for skilled nursing some in-home services, as well as meals, social activities and medical services in a center. 

In 2021, Sen. Bob Casey (D-PA) introduced the PACE Plus Act which would expand the program through federal grants and provide technical assistance to help organizations launch programs.