> Managed Care Options
Healthcare has changed markedly over the years. In Massachusetts the approach to service for Medicare recipients and those considered dual eligible is geared to comprehensive community care. Inter-disciplinary teams work collaboratively to address a patient’s needs whether it is preventative care, managing chronic illness, or addressing an acute health problem. Some of the options are:
Senior Care Organizations
Senior Care Options is a partnership between MassHealth and Medicare that provides an integrated and complete package of health care and social services for low-income seniors over the age of 65. Services are managed by an Registered Nurse and a Geriatric Support Services Coordinator (GSSC) who work in partnership with a medical team to ensure consumers long term care needs are met, and elders can remain living in the community. Seniors who have MassHealth Standard coverage but do not have Medicare can choose a Senior Care Options SCO plan. One of the main goals of Senior Care Options is to help seniors stay healthy, in control of their lives, and out of nursing homes.
Our Senior Care Options partners are:
Care One Plan (Integrated Care Organization)
Elder Services of the Merrimack Valley, Inc. (ESMV) in partnership with Commonwealth Care Alliance is participating the One Care Program to provide services and supports to people between the ages of 21-64 who are disabled. The program is scheduled to begin in October 2013.
Long Term Support Services Coordinator’s have been hired and will begin training in September 2013. All ESMV Home Care staff received educational training to better understand how to better support the needs of the new population being served.
Programs for All Inclusive Care for the Elderly (PACE)
PACE is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility. With PACE, the focus is on consumer— a team of health care professionals are assigned to work with the consumer and their family to make sure you get the coordinated care they need.
How does PACE work?
PACE organizations provide care and services in the home, the community, and the PACE center. They have contracts with many specialists and other providers in the community to make sure that you get the care you need. Many PACE participants get most of their care from staff employed by the PACE organization in the PACE center. PACE centers meet state and federal safety requirements.
Who can get PACE?
You can have either Medicare or Medicaid, or both, to join PACE. To qualify for PACE, you must:
- Be 55 or older
- Live in the service area of a PACE organization
- Need a nursing home-level of care (as certified by your state)
- Be able to live safely in the community with help from PACE