ABOUT THIS EPISODE
In our latest episode of our Think BIG and LOUD podcast, host Beth Peterson sat down with Dr. Suzana Simoes, Physical Therapist and Director of Rehabilitation services at Florida Pace Centers, to explore a model of care that is quietly transforming how frail older adults stay safe, mobile, and connected in their own communities.
WHAT IS PACE?
All-inclusive care without the nursing home
PACE, Program of All-Inclusive Care for the Elderly, is a federally capitated insurance model that coordinates every aspect of healthcare for adults 55 and older who qualify for nursing home placement but choose to remain at home. Participants pay nothing out of pocket; PACE covers medications, therapy, transportation, home care, respite for caregivers, and more.
202
PACE programs across the US
396
Care centers nationwide
33
States with PACE programs
50%
Of participants in active therapy at any time
What separates PACE from traditional outpatient or home health models is its emphasis on prevention over reaction, keeping people out of hospitals and nursing facilities in the first place. Physicians, nurses, therapists, social workers, and dieticians meet together every morning to discuss participants by name.
THERAPY AT PACE
From skilled rehab to lifelong maintenance
Because PACE follows participants for years, sometimes for the rest of their lives, therapy can extend far beyond a typical discharge. Dr. Simoes described a quality improvement study she conducted tracking 200 PACE enrollees over one year. Participants began with an average Short Physical Performance Battery (SPPB) score of around 6 out of 12, a level where rates of mortality and hospitalization begin to climb sharply.
Six months in, those who received physical therapy showed significantly greater mobility gains than those who did not. A year later, the improvements held: the program’s restorative maintenance system had kept participants at their improved levels.
LSVT AND PACE
Why LSVT BIG and LOUD are a natural fit
With a growing number of PACE participants living with Parkinson’s disease, Dr. Simoes sees a clear opportunity to integrate LSVT BIG and LSVT LOUD into the PACE model. The intensive four-week protocol can be delivered at the center, and the long-term relationship between therapists and participants makes ongoing maintenance, weekly sessions, restorative groups, home exercise check-ins, entirely realistic.
Dr. Simoes also shared a memorable early-career case: a physician newly diagnosed with Parkinson’s who scored entirely normal on standard mobility and balance assessments. It was only when she used the LSVT BIG exercises as a diagnostic tool, with their demands for coordinated upper and lower extremity movement, motor planning, and executive function, that his deficits became visible. The case became a poster presentation at the APTA Combined Sections Meeting.
KEY TAKEAWAY
True interdisciplinary care is rare, PACE delivers it
Dr. Simoes made a distinction worth remembering: multidisciplinary means many professionals are present. Interdisciplinary means they are actively collaborating around a shared participant goal. PACE is built on the latter, daily team huddles, coordinated fall prevention committees, and a shared mission of keeping older adults vibrant at home.
For families exploring care options for an aging loved one, or clinicians looking for a practice environment where the focus stays on the patient, PACE is worth knowing about. You can find your local program through the National PACE Association (npaonline.org) or visit the Florida PACE Centers website for information specific to South Florida.
This post is based on Dr. Suzana Simoes appearance on the Think BIG and LOUD Podcast from LSVT Global. Listen to the full podcast episode.
To find an LSVT certified therapist in your area, visit lsvtglobal.com.
AI (Claude) assisted in the translation of this content from a podcast to a blog, edited by humans of course.