Navigating the Challenges of Launching a PACE Program: Do’s and Don'ts
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Starting a new PACE program is no small feat, with the process being complex, expensive, and time consuming. In our experience supporting PACE organizations and organizations looking to add a new program, there are two critical areas where a lack of understanding commonly occurs.
Misunderstandings
1. The Front-End Investment: Beyond Dollars and Cents
First, starting a PACE program requires a significant investment both financially and operationally. This includes a physical building, organizational structures, PACE policies, procedures, and even hiring a team. Financial investment easily exceeds millions of dollars to complete the initial checklist and before drawing in any revenue. Understanding the meticulous groundwork involved is paramount.
2. The Depth and Breadth of PACE: More Than Just Healthcare
The second major misunderstanding is it's not just about setting up a program; it's about establishing a robust foundation that aligns with the unique philosophy of PACE which is not a typical healthcare model—it's a paradigm shift. Those in the healthcare space and similar models may not understand the complexities of the program. PACE onboarding for interdisciplinary team members is similar to a year-long apprenticeship to understand the unique longitudinal model of team-driven care. The other unique aspect of the model is the autonomy for the participant, and learning how to navigate the moral and ethical considerations for care by supporting the individual to make choices which require risk to preserve their dignity. It is imperative for organizations to grasp the philosophy behind PACE, understand its nuances, and align their operations accordingly.
Hurdles to Overcome
With these two misconceptions into consideration, there are three hurdles worth considering exploring a new PACE program.
First is the application process itself. It is a long and cumbersome process, by design. A PACE program isn’t just a physician practice – it is a full, community-based model with integrated acute and long-term care. Oftentimes, programs need outside expertise for the application to ensure the right level of professionalism, accuracy, and attention to detail for the state administrating agency and CMS.
Second is customizing policies and procedures to fit the unique culture of the community served. It's not just about being regulatory compliant; it's about resonating with the local population and understanding their specific needs and expectations. “If you’ve seen one PACE program…you’ve seen one PACE program”. PACE organizations serve adults 55 and older that qualify for nursing home-level care but each community and each geography have its own culture, and it is critical for each PACE program to meet those unique needs.
The final hurdle is the first trial period audit. You’ve submitted the application, planned the program, and catered it to your community’s unique culture. The audit will show if all of that was done in a way that is compliant with the various regulations. Failure to comprehend both the spirit and application of these regulations can lead to unpleasant surprises during the audit.
In navigating PACE startup process, we hope these insights provide a roadmap for organizations to open successfully in the challenging yet rewarding world of elderly care through the PACE model. In our next blog, we will tackle ways to navigate program growth – both for programs struggling to grow and those that are growing quickly.
Contact Intus Care to learn more about how we can support the growth of your PACE program through our website contact page.
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