|
Rural
Seniors with Long Term Care Needs
Offered Help in New Report
Two
national associations work together, share expertise
Feb.
22, 2003 - The National PACE Association (NPA)
and the National Rural Health Association (NRHA)
published a new report today, Setting
the PACE for Rural Elder Care: A Framework for Action,
providing a blueprint to improve the care for many seniors with long term
care needs who live in rural areas while saving state and federal health
care dollars by expanding access to Programs of All-inclusive care for the
Elderly (PACE).
PACE
programs serve people over age 55 who meet their state’s criteria for
needing nursing home care, with a goal of helping them to live in the
community. PACE has been shown to provide better clinical outcomes and
higher rates of consumer satisfaction, while cutting costs to federal and
state governments.
Today
PACE only serves older people living in urban areas. However, rural
areas of America have a disproportionate number of older Americans, with
18 percent of the population over age 65. Of these Americans, many lack
adequate income to afford needed health care, and face more difficulty
receiving care than their urban counterparts because of uniquely rural
factors, such as the shortage of health care professionals, the distances
between service providers and the lack of low-cost public transportation
for residents
Interdisciplinary
teams of professionals both provide and coordinate preventive, primary,
acute and long term care services in PACE with an emphasis on keeping
older individuals in the community. Program sponsors are reimbursed
by Medicare and Medicaid based on a capitated rate for each eligible
person who enrolls, so teams can deliver specific types of care and
services to help each individual live as successfully in the community as
possible. Because the program combines Medicare and Medicaid funding
into one seamless program, it is proven effective in enabling even
low-income person with few resources to continue living in the community.
“One
key to a program like PACE is being able to enroll enough individuals in
the program to support the program’s costs,” Shawn Bloom, president
and CEO of NPA, said. “Being able to serve an adequate number of
individuals to cover the cost of the program is more difficult in a rural
area where fewer numbers of people are spread over greater distances.”
Although
many rural communities have the resources and know-how to implement PACE
programs, they need access to start-up funding and more flexibility with
the PACE model than urban-based PACE sponsors, according to participants
at the September 2002 “Rural PACE Summit,” co-sponsored by NPA
and NRHA and supported by grant funds from The Robert Wood Johnson and
John A. Hartford Foundations.
“Many
rural communities have the ability to operate effective and beneficial
PACE programs,” NRHA executive director Steve Wilhide, MSW, MPH said.
“We need to work to ensure they receive adequate funding to help them
get started and the flexibility they will need to successfully adapt the
PACE model to various rural settings.”
As of January 2003, there were 28 PACE programs, all operating in
urban areas. To ensure success in rural areas, program supporters say the
program will need to be able to attract an adequate number of community
members to enroll in the program.
After years of success as Medicare and Medicaid demonstration programs,
PACE programs are in the process of becoming permanent providers under
both the federal
Medicare
program and the state’s Medicaid program. Many state and
federal long term care health policy experts, including the Centers for
Medicare and Medicaid Services (CMS) Administrator Thomas Scully, have
expressed support for expanding the PACE model into rural areas.
Diane Braunstein, program director of health policy studies at the
National Governors Association, echoes Scully saying, “Efforts to expand
programs like PACE into rural areas are important as states continue to
seek out new ways to deliver services to rural elders.”
While acknowledging that a rural PACE model could take many different
forms, advocates are focusing on two likely scenarios such models might
follow.
The Rural Network Model would be based on a high level of collaboration
between many different providers serving a rural area. Health care
providers in rural communities have a tradition of working together to
provide for the community’s health care needs, as no single organization
would have the resources or know-how to handle the services individually.
In theory, the PACE model could adapt so several different organizations
could work together.
Another model is the Rural-Urban Linkage Model based on partnerships
between an urban-based PACE sponsor and rural health care providers in the
area. While these partnerships could take many forms, they have the
potential to offer several benefits, including specialized services,
sharing of administrative costs and financial risks.
As
a next step, NPA and NRHA are working together to build support in the
Bush administration and Congress for a rural PACE demonstration program.
The
National PACE Association works to advance the efforts of Programs of
All-inclusive Care for the Elderly (PACE) to support, maintain, safeguard
and promote the provision of quality, comprehensive and cost-effective
health care services for frail older adults.
The
NRHA is a national nonprofit membership organization that provides
leadership on rural health issues. The association’s mission is to
improve the health of rural Americans and to provide leadership on rural
health issues through advocacy, communications, education and research.
The NRHA membership is made up of a diverse collection of individuals and
organizations.
|