PACE vs. Medicare Advantage

Let's compare outcomes for people with PACE to people with regular Medicare Advantage. We are only comparing outcomes among people who have full Medicaid, which has income limits to get. I am using the term Full Medicaid, which in healthcare jargon is "dual eligible."

The full report is available for download at the bottom of this page.

People with PACE have more medical conditions than regular Medicare Advantage (which I will refer to now as MA), yet here is what the data show:

People with MA are 4x as likely to spend 1 month in an institution than people in PACE:

In MA, 24.6% of patients were institutionalized at least 1 month, compared to 6.4% of PACE participants.

People with MA are 3x as likely to spend more than 1 month in an institution than people in PACE.

In MA, 21.1% of patients were in Long-Term Institutional [care] over 1 month, compared to 7.5% of PACE participants.

All this means with PACE, people spend more time at home and less time in long term care.

About 1 in 3 people with regular MA will go to the emergency room, but only 1 in 4 people with PACE:

In MA, 30.7% of patients had Any Emergency Department Visit, compared to 24.8% of PACE participants.

Fewer visits to the Emergency Room is always better for anybody. Preventative care and personal attention makes the difference.

Be careful with this data.

Here, I am comparing PACE with regular MA.

I am not comparing PACE with Dual Special Needs Plan from Medicare Advantage. Those plans are called "D-SNIPS" in healthcare jargon. D-SNIPS and PACE are both integrated care models. Their health outcomes are generally similar.

What PACE has that D-SNIPS don't is the social togetherness component, once twice or three times a week visits to a PACE center, full of activities and caring staff.