PACE most commonly stands for Program of All-Inclusive Care for the Elderly, a healthcare model that helps older adults receive medical and social services while continuing to live at home instead of moving into a nursing facility. In a completely different context, PACE also stands for Property Assessed Clean Energy, a financing tool for energy-efficient home improvements. Here’s what each one means and how it works.
PACE in Healthcare
The Program of All-Inclusive Care for the Elderly is a combined Medicare and Medicaid program designed for people who are frail enough to qualify for nursing home care but still able to live safely in their communities. Rather than moving into a facility, participants visit a PACE center during the day and receive a wide range of medical, social, and support services coordinated by a single team.
The program covers essentially everything a participant needs to stay healthy and independent. That includes primary care, hospital care, prescription drugs, physical and occupational therapy, mental health counseling, dentistry, home care, nutritional counseling, and even transportation to and from the PACE center and medical appointments. If the care team determines you need a service, PACE covers it, even if it falls outside what Medicare or Medicaid would normally pay for.
Who Qualifies
To enroll, you need to meet four conditions: be 55 or older, live in the service area of a PACE organization, be certified as eligible for nursing home-level care by your state, and be able to live safely in the community at the time you join. People who qualify for both Medicare and Medicaid typically pay nothing out of pocket. Those who have Medicare but not Medicaid may pay a monthly premium to cover the long-term care portion.
How PACE Compares to Nursing Home Care
A major CMS evaluation found that PACE participants had significantly better outcomes than similar individuals who received traditional care. At six months, PACE enrollees were 50 percent less likely to have been hospitalized, and they averaged just 1.9 nights in the hospital compared to 6.1 nights for the comparison group. By 12 months, PACE participants still spent nearly three fewer nights hospitalized.
The survival data is equally striking. Controlling for baseline health, a person with average characteristics had a median life expectancy of 5.2 years in PACE versus 3.9 years in the comparison group, a 33 percent difference. The likelihood of dying within a year of enrollment was about 10 percent for PACE participants, compared to roughly 13.5 percent for those receiving standard care. These outcomes reflect what happens when a single coordinated team manages every aspect of a frail person’s health rather than leaving them to navigate fragmented services on their own.
PACE in Clean Energy Financing
Property Assessed Clean Energy, or PACE, is a financing tool that lets property owners pay for energy efficiency upgrades, water conservation projects, and renewable energy installations without covering the full cost upfront. Instead of taking out a traditional loan, the cost is added as an assessment on your property tax bill and repaid over the useful life of the equipment you installed.
The key feature is that the debt attaches to the property, not to the person. If you sell the home, the buyer can assume the remaining PACE payments along with the benefits of the upgrades. If the buyer doesn’t agree to take them on, you’d need to pay off the outstanding balance at the time of sale. Your local government typically collects the payments and passes them along to the financing company.
Risks to Know About
Because PACE assessments are collected through property taxes, they carry the same weight as a property tax lien. The Consumer Financial Protection Bureau warns that you can lose your home if you fall behind on payments, just as you could with unpaid property taxes. This makes PACE financing fundamentally different from a standard home improvement loan, where the consequences of missed payments are less immediate. Before signing up, it’s worth understanding that this obligation takes priority over your mortgage in most cases, which is why some mortgage lenders have raised concerns about the program.
Other Uses of the Acronym
Beyond these two major programs, PACE appears in several other contexts. In education, it sometimes refers to individualized learning curricula. In the military, it can describe a planning framework. In fitness, “pace” is simply the speed at which you run or walk per mile or kilometer. But if you encountered the acronym in a healthcare or home financing context, the two meanings above are almost certainly what you’re looking for.