Headline

Qualitative research reveals key facilitators of access to PACE programs among Black and Latino older adults.  

Context

The Program of All-Inclusive Care for the Elderly (PACE) is an established model for serving older adults with functional limitations and other chronic care needs who are dually eligible for Medicare and Medicaid. PACE is associated with improved health outcomes and can enable individuals to avoid institutional care and remain in home and community-based settings longer. Black and Hispanic older adults, however, are more likely to be placed in institutional care, specifically nursing homes, and experience poorer outcomes in these settings. This study identifies key facilitators for accessing PACE among Black and Latino older adults, to support greater equity in access to these programs.

Findings

This study analyzed focus groups and semi-structured interviews involving 32 PACE enrollees, six marketing team members, and four family caregivers from three PACE sites in Philadelphia, Pennsylvania. Key facilitators for accessing PACE among Black and Latino older adults included knowledge of PACE, primarily gained through word of mouth, and referrals from community-based health care providers. Conversely, language barriers and culturally insensitive care were identified as common obstacles to accessing these programs. PACE enrollees highlighted the use of interdisciplinary care teams, functional supports, and the availability of a wide range of health and social services as key benefits of PACE.

Takeaways

By drawing on multiple forms of qualitative data, the authors shed light on the nuanced experiences of Black and Latino older adults in accessing PACE, providing insights that are often indiscernible through quantitative data alone. This research can inform policy and program design to increase equitable access to PACE. In particular, the authors suggest that educating community providers about PACE benefits may help to expand access.