As U.S. national and state policies for elder care evolve, this report offers a depiction of efforts by a provider of the Program of All-inclusive Care for the Elderly (PACE)—WelbeHealth—to adapt its care delivery in the face of the COVID-19 crisis. It is meant as an illustrative example of the adaptation of one elder care model, the PACE model, to a pandemic crisis in which remote care becomes essential. PACE providers offer high-touch, team-based care to frail seniors who live at home but regularly visit a center where medical, social, and other services are provided. Through interviews with leadership and staff the study describes WelbeHealth’s implementation of a hybridized model of home care under COVID-19, enabled by the flexible nature of PACE programs, allowing for a safe and context-appropriate response to patient needs, while also recognizing that certain memory and health conditions are much harder to treat without in-person engagement. WelbeHealth acted early and decisively to minimize exposure with an incident response strategy, dispersing tablets for telehealth visits, PPE, thermometers, food, medication and other essentials into participants’ homes, and providing nearly all care remotely, which proved effective. Notably, WelbeHealth reported a 2.4% death rate from the disease, other PACE programs nationwide averaged 3.8%, whereas nursing homes averaged a 11.8% death rate.1 In the context of evolving policy debates, the study suggests that the PACE model merits consideration as part of a systematic study comparing models of long-term care including home and community-based services.
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[1] See: https://www.npaonline.org/covid-19-information-and-resources/covid-19-data (registration required)