Under the Programs for All-Inclusive Care of the Elderly (PACE) model, patients generally do not transition to the Medicare Hospice Benefit as they near death. Consequently, Empath Health has taken pains to ensure quality end-of-life care is integrated into its program.

Empath considers these services to be a key component of its “Full Life Care” model, that seeks to longitudinally support patients over the course of their serious or terminal illness, according to Dr. Nick Joseph, senior vice president of Empath’s Complete Care Division. The organization provides end-of-life care in the home, with services that mirror its hospice program.

“Because we are part of one of the nation’s largest not-for-profit hospice networks, our PACE participants have access to exceptional end-of-life care with no disruptions in trust or quality,” Joseph told Hospice News in an email.

Empath Health is the parent company of 17 affiliates and four philanthropic foundations. The organization provides care to more than 81,000 patients annually. In addition to PACE, the nonprofit’s Full Life Care model includes hospice, home health care, palliative care, bereavement, adult day and primary care services, advance care planning, HIV and sexual health services, and pharmacy and medical equipment assistance.

The organization’s PACE program — branded as Empath LIFE (Living Independence for the Elderly) — is designed to help adults aged 55 and older remain safely in their homes and communities rather than transitioning to nursing homes. The program includes a comprehensive suite of services, including medical care, therapies, transportation, medication management and day center activities. 

Palliative care is also woven into the PACE model’s fabric, according to Laura Ryan, vice president of business development for Empath Health. This includes regular assessments, symptom management, advance care planning and ongoing conversations about goals and preferences. Psychosocial and spiritual support are also built into the model.

“We don’t just focus on treating medical conditions—we focus on helping people live fully, PACE allows us to surround participants with the support they need, while honoring their independence and choices,” Joseph said.

PACE programs like Empath LIFE are primarily reimbursed through capitated payments from Medicare and Medicaid. Once a participant is enrolled, they agree to receive all of their covered care exclusively through the PACE provider, which in turn receives a fixed monthly payment per member. If a participant doesn’t qualify for Medicaid, they may pay a monthly premium.

Most PACE programs take three to five years to break even, according to Ryan. The timeline is influenced by factors such as enrollment growth, the ability to manage complex care efficiently and reductions in high-cost interventions like hospitalizations.

“Sustainability in PACE comes from doing the right thing clinically — preventing crises before they occur and keeping participants well in the community,” Ryan told Hospice News in an email. “That’s where quality and financial performance align.”