Oregon health officials have released a request for proposals (RFP) to expand its Program of All-Inclusive Care for the Elderly (PACE) services throughout the state.
The Oregon Department of Human Services (ODHS) released the RFP through its Office of Aging and People with Disabilities (APD). It states that APD is issuing the request for new PACE providers in areas not currently being served by an active PACE organization.
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PACE is available to people with Medicaid and Medicare coverage, and provides medical and social services to residents 55 and older living at home or in care settings like adult day centers and nursing homes. It is a care model that combines all medical services, long-term care services, and social services into one program.
APD’s Jane-ellen Weidanz discussed plans to expand PACE during a House Interim Committee on Human Services meeting in June 2022. She said the program uses two providers: Providence ElderPlace serves all of Multnomah and Clatsop counties, as well as parts of Washington, Tillamook, and Clackamas counties, while AllCare PACE serves parts of Jackson and Josephine counties through a health center in Grants Pass.
However, PACE officials want to expand the program to cover every county, Weidanz said, and had heard from several providers that they want to enter the PACE market, mostly in the mid-Willamette Valley area.
When discussing plans to develop an RFP, Weidanz said officials would consider vendor criteria including service equity, expanded coverage areas (providers that will offer services in rural areas, and are not limited to serving people strictly in urban areas), and the ability to be operational within 365 days.
The RFP states that PACE organizations receive a monthly capitated payment through Medicare and Medicaid (if the participant is receiving Medicaid benefits). PACE organizations are capitated to provide all Oregon Health Program and long-term services and support benefits. Rates are set to be no more than what it costs the state to serve similar consumers, and are specific to the region or PACE organization.
ODHS anticipates the award of one or more contracts from the RFP, depending on the number of proposals received and the areas in which services are proposed. The initial term of any awarded contract is anticipated to be on Dec. 31st, with options to amend yearly for annual contract periods of January through December, to align with new capitated payment rates if new rates are established, up to a cumulative maximum of 10 years.
Proposers can submit a proposal for more than one service area; but the zip codes within each service area must be contiguous, according to the RFP. Proposals can be submitted for Baker, Benton, Coos, Crook, Curry, Deschutes, Douglas, Jefferson, Gilliam, Grant, Harney, Hood River, Jefferson, Lake, Lane, Lincoln, Linn, Malheur, Marion, Morrow, Polk, Sherman, Umatilla, Union, Wallowa, Wasco, and Wheeler counties.