title: Stability of disability among PACE enrollees: financial and programmatic implications.
abstract: This article examines the experience of the first 11 Program of All-inclusive Care for the Elderly (PACE) programs. It investigates changes in functional status of participants in relation to length of enrollment in the program and individual risk characteristics. Our findings indicate that mature programs experience stable disability mix over time, supporting the rationale for the current PACE payment method. However, significant differences exist between programs, suggesting that payment rates could be more program specific. Analysis of the effect of patient characteristics at admission on the likelihood of improvement in functional status identified areas for quality improvement. The implications of this study have increasing importance in light of the expected expansion of PACE to approximately 100 sites by the year 2000.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Mukamel
authors.forename: H
authors.initials: H
authors.lastname: Temkin-Greener
authors.forename: M L
authors.initials: ML
authors.lastname: Clark
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002204:Capitation Fee; D003191:Comprehensive Health Care / Q000191:economics* / Q000458:organization & administration; D003953:Diagnosis-Related Groups; D006233:Persons with Disabilities; D006279:Health Maintenance Organizations / Q000191:economics*; D006299:Health Services for the Aged / Q000191:economics* / Q000458:organization & administration; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000458:organization & administration; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D010865:Pilot Projects; D015397:Program Evaluation; D011787:Quality of Health Care; D020127:Recovery of Function; D012307:Risk Factors; D014481:United States