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CMS Seeking Comments on PACE-like Models of Care

The Centers for Medicare & Medicaid Services (CMS) has released a Request for Information (RFI) seeking public input on potential adaptations of the model of care employed by the Programs of All-Inclusive Care for the Elderly (PACE) for new populations, including individuals with physical disabilities. The PACE Innovation Act of 2015 (PIA) provides authority 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.

Following the enactment of the PIA, CMS conducted extensive stakeholder outreach on the applicability of the PACE model of care for people with disabilities. Informed by this outreach, CMS has developed an outline of a PACE-like model provisionally named "Person Centered Community Care," or P3C. This potential model is designed to meet the requirements of a model test under the PIA and to adapt the PACE model of care for one population of focus.

The model recognizes the need to adapt existing PACE requirements so that the P3C services support enhanced community integration for people with disabilities and offer a targeted, appropriate balance between medical care and the broader range of supports that younger people with mobility-related disabilities may require to maximize independence.

The RFI includes two parts:

  • In the first part, CMS seeks comment on potential elements of a five-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, among other eligibility criteria. In addition to feedback on the potential elements of the P3C model described in the RFI, CMS seeks comment on the types of technical assistance that potential P3C organizations and states would require to participate in the model test.
  • In the second part, CMS seeks 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. 

The federal request and discussion comes as the state prepares for stakeholder discussions in 2017 on potential enhancements or alternatives to the Fully Integrated Duals Advantage (FIDA) demonstration, which shares a number of features with PACE. Comments are due by 5 p.m. EST on Feb. 10, 2017 and should be submitted electronically in PDF form to MMCOcapsmodel@cms.hhs.gov. If commenting, please share your comments with us as well. The RFI is available here

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841