Fallon Health to expand PACE services

Photo | Grant Welker Fallon Health's Worcester headquarters

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By Alexander MacDougall

Worcester insurer Fallon Health announced on Tuesday it was expanding the areas of availability for its Program of All-Inclusive Care for the Elderly, or PACE, which is now available to adults in over 270 zip codes 10 counties.

The program, which exists across several states and is run by MassHealth in Massachusetts, has been included for Fallon customers since 1995 as part of the company’s Summit ElderCare program. The new expansion now includes adults in the city of Framingham, which previously never had access to any PACE services from any insurance provider, said Melissa Randall, a spokesperson for Fallon Health.

“Older adults who live there have never been able to use PACE, because it just hasn’t been an option,” Randall said. “Now we have that reach, and older adults in Framingham have an alternative to nursing home care.”

The program is eligible for any adult over the age of 55 who requires a nursing home level of care and who lives within a specified coverage area of a PACE provider. It allows participants to continue living at home while still receiving the level of care that they require.

Kristine Bostek, who serves as senior vice president of PACE programs from Fallon, said although the service is administered by the state, there remain many who live outside of a coverage area and are therefore unable to receive services from the program.

“There are many communities still in Massachusetts where there is no PACE as an option,” Bostek said. “The goal of the state is to close those gaps and ultimately, to be able to say that PACE is an option for all towns and cities in Massachusetts.”

Fallon operates five facilities providing PACE in Worcester, Webster, Lowell, Springfield, and Leominster. Under the new expansion, anyone who lives within a 35-mile radius of any of those five facilities is eligible to partake in PACE.

The program has seen renewed interest following the COVID-19 pandemic, with vulnerable members of older adults able to make use of PACE services to remain at home and avoid potential infections at nursing homes. According to the National PACE Association, PACE participants contacted the virus at only one-third of the rate that nursing home residents did.

In a press release announcing Fallon’s expansion, Randi Berkowitz, the company’s vice president and medical director for its Summit ElderCare program, stressed the ability of pace to keep vulnerable elderly patients at home.

“Now, more than ever, families are looking for choices that include keeping their loved ones safe at home,” said Berkowitz. “The PACE model of care is uniquely positioned to support the needs of older adults.”