How the Program of All-Inclusive Care for the Elderly Can Meet the Needs of Dually Eligible Individuals in Rural Communities

December 2023

People who are dually eligible for Medicare and Medicaid must navigate fragmented, uncoordinated systems of care and can benefit from a holistic, person-centered approach to care coordination that integrates their Medicare and Medicaid coverage. Twenty percent of dually eligible individuals live in rural areas where access to models that integrate Medicare and Medicaid services, such as Medicare Advantage Dual Eligible Special Needs Plans are limited.

The Program of All-Inclusive Care for the Elderly (PACE) is designed to meet the physical health, long-term care, and social support needs of individuals aged 55 and older. PACE is a well-established integrated care model that provides high-quality, cost-effective care. With its adult day health center structure and in-house, interdisciplinary care teams, PACE can serve older adults with complex health and social needs who live in rural areas.

This 60-minute Better Care Playbook webinar, made possible through support from the Seven Foundation Collaborative, explored how PACE offers a unique opportunity to address the needs of dually eligible individuals who live in rural communities. It featured perspectives from a rural PACE provider as well as a state that is seeking to offer PACE statewide, including in its rural counties.

Presenters included Shawn Sullivan, President and Chief Executive Officer, Midland Care (Kansas) and Erin Slabonik and Randy Nolen, Pennsylvania Office of Long-Term Living. Ample opportunities were available for participants to ask questions.


I. Welcome and Introduction

Speaker: Nancy Archibald, Center for Health Care Strategies (CHCS)

N. Archibald welcomed participants and provided a brief introduction on the characteristics of individuals dually eligible for Medicare and Medicaid and how this population is served by PACE.

II. PACE Provider Perspective on Serving Dually Eligible Individuals in Rural Communities

Speaker: Shawn Sullivan, President and Chief Executive Officer, Midland Care (Kansas)

S. Sullivan discussed opportunities and challenges of setting up and operating PACE organizations to serve rural communities.

III. State Considerations for PACE Expansion, Provider Recruitment, and Health Equity

Speakers:  Erin Slabonik, Division Director, and Randy Nolan, Bureau Director, Pennsylvania Division of Integrated Care Programs, Bureau of Coordinated and Integrated Services, Office of Long-Term Living

E. Slabonik and R. Nolen provided a state perspective on how PACE programs can serve rural communities as well as considerations for states regarding expanding PACE statewide, recruiting rural PACE providers, and addressing issues of health equity in rural expansion.

IV. Moderated Q&A

Moderator: Nancy Archibald, CHCS

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