The Program of All-Inclusive Care for the Elderly (PACE) model is set up to support aging populations with diverse medical and nonmedical needs. This notion, in part, drove BoldAge PACE to unveil a new center in South Carolina.

The company’s strategic growth decisions have largely focused on geographic regions where the greatest level of unmet needs exist, said Rob Williams Sr., PACE executive director at BoldAge. Williams will oversee the new location in North Charleston, South Carolina, which was chosen largely due to the area’s high incidences of stroke-related mortalities, he stated.

The region rests in what is referred to as the Stroke Belt, a pocket of Southeastern states with stroke mortality rates 2x to 4x higher than the rest of the country, reported the American Heart Association Journals. These regions include rural and urban areas of patients with various racial, ethnic and cultural backgrounds.

Expanding PACE services into these underserved areas has come with positive impacts on outcomes and access among serious and terminally ill patients, Williams said.

“Our bold strategy focuses on regions where there are significant gaps in care for underserved adults,” Williams told Hospice News. “With South Carolina being part of the Stroke Belt … it has growing aging populations with limited health care options tailored to their unique needs. There’s high incidences of diabetes, hypertension in these really diverse areas [and] there’s a big health equity gap within the community. In both rural and urban communities, access to integrated services like PACE can make a profound difference in quality of life.”

New Jersey-headquartered BoldAge PACE emerged in 2023, established by a group of former hospice and home health leaders. The company has been on a growth path ever since its launch, currently operating 14 locations across 8 states.

BoldAge provides care to more than 400 individuals in New Jersey, California, Indiana, Kentucky and South Carolina. The company’s de novo strategy includes plans to open 10 new PACE centers by 2026, with three locations planned in Ohio.

Demographic trends are fueling BoldAge’s strategic growth. Seniors 60 and older are projected to represent nearly a third (27%) of South Carolina’s overall population by 2030, a 5% rise from 2020, the U.S. Census Bureau reported. Hospice utilization rates reached 51.81% among Medicare decedents during 2022, which was above the national average of 49.1% that year, according to National Alliance for Care at Home.

Socioeconomic trends are also a strategic factor, Williams indicated. Black, Hispanic, American Indian and Alaska Native, Asian, Native Hawaiian and Pacific Islander populations represent a combined 38.4% of South Carolina’s population, the U.S. Census Bureau reported.

PACE programs can help address common barriers experienced among underserved populations with significant medical and social determinants of health needs, Williams indicated. For instance, these services help aging populations maintain quality of life by avoiding unnecessary hospitalizations and placement in long-term care facilities.

PACE programs help provide assistance with transportation to medical appointments, adult day services, advance care planning, durable medical equipment and medication management, among other services. PACE providers can additionally help connect hospice patients to find transitional care when revocations and live discharges occur. These programs also help ensure smooth care transitions and timely access by collaborating with hospice providers within their service regions when patients are nearing the end of life, Williams said.

“It’s a win-win partnership. Our interdisciplinary PACE teams help remove barriers that some people have in finding the right hospice for them,” Williams said. “The PACE and hospice relationship is important. The holistic approach should be [spelled] with a ‘w,’ because we’re looking at the whole portion of an individual’s comprehensive care planning and delivery. We collaborate from an interdisciplinary perspective and transition patients to services that are needed.”