Why PACE Expansion Is Entering A New Era

A rare level of bipartisan validation

Unequivocally, PACE is the most effective solution for the U.S. senior population’s most complex needs. It is rare for a care model to earn unanimous praise across the aisle, yet the Program of All-Inclusive Care for the Elderly has done exactly that, gaining rare bipartisan backing at the federal level.

The recent signing of H.R. 7148 saw Congress call on CMS to “move forward expeditiously on PACE-specific model tests.” This policy momentum follows the passage of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act in early 2025, which opened a significant new bridge between the PACE model and the millions of veterans who will need it.

Shawn Bloom, president and CEO of the National PACE Association (NPA), offered a clear explanation: “further expansion of PACE enjoys bipartisan support because it is a model of care that works economically and toward the benefit of the health of our seniors.”

These policy advancements mark a fundamental shift in federal confidence in the program. PACE has long delivered exceptional results but has scaled incrementally, making this level of validation particularly significant. These policy tailwinds signal that PACE is moving beyond a niche alternative and is increasingly viewed as a credible, policy-endorsed cornerstone of preventative value-based care models.

I believe, as a result of these tailwinds and other accelerating market forces, the national PACE census will grow to 250,000 members by year-end 2030.

Why this recognition matters now

PACE has demonstrated value for decades, but adoption has been measured relative to the size of a growing eligible population. As of December 2025, more than 90,000 participants across 33 states were enrolled in the program: representing less than 5% of the estimated two million eligible participants.

As healthcare systems continue to face rising complexity, labor shortages, and an aging population with higher acuity needs, PACE emerges as an underutilized solution with immense runway for expansion. The model’s fully capitated structure and interdisciplinary design align with policymakers’ prioritization of models that connect quality with financial accountability.

Funding follows confidence

Importantly, we see PACE momentum extending beyond model validation with recent state-level expansion efforts. Recent reports outline that the $50 billion Rural Healthcare Transformation Program is being leveraged by states to ease Medicaid pressures and strengthen care delivery in historically underserved communities. Nine states are already moving to use these funds to either launch new PACE programs or scale existing ones. Bipartisan validation and significant state-level budget allocations signal that the conversation has moved beyond recognition and should now focus on how the model can best succeed and meet these expectations.

The leadership challenge: Scaling without fragmenting

With expansion, however, comes heightened execution risk. As programs scale, particularly into rural or resource-constrained settings, their operational complexity increases exponentially.

The PACE model works because its fully integrated design is built around the principle that better patient outcomes and disciplined utilization control are mutually reinforcing. Interdisciplinary coordination, proactive care planning, and rigorous documentation are the engines of its success, enabling teams to manage risk longitudinally rather than episodically. As we move into this new era, leadership’s primary responsibility is to ensure that “growth” does not result in the dilution of the model’s core strengths.

Without the right systems in place, rapid expansion risks introducing fragmentation—the very problem PACE was designed to solve.

Infrastructure: The “force multiplier” for growth

To ensure expansion readiness, modern technology must function as the core infrastructure necessary to scale the impact of PACE, while reinforcing the integrity of the IDT model. Simple and legacy tools to alleviate administrative burdens will inhibit PACE from pulling into the future.

Core infrastructure should perform as the fabric that streamlines care coordination and provides visibility into the care journey, keeping teams laser-focused on participants while keeping operations sustainable. As smaller programs seek to meet this policy opportunity and scale across multiple geographies and larger populations, that infrastructure must amplify the model in its fullest form while navigating potential growing pains.

Clinical teams need clear, real-time visibility into participant risk to deliver proactive, participant-centered care. As programs scale, purpose-built platforms must continue to preserve the synchronization of the IDT plan to ensure care plans, documentation and decisions remain aligned when care is delivered. Enrollment increases bring greater clinical complexity, and revenue capture must accurately reflect that complexity while cost controls limit unnecessary utilization. At the same time, embedded workflows and defensible documentation will be essential in preserving the program’s integrity and safeguarding against regulatory risk.

From validation to responsible scale

As the national dialogue reaches a defining moment, the evidence, outcomes, and policy signals all point in the same direction: PACE is the path forward for complex senior care.

Through this lens, technology and services can provide the operational foundation that allows programs to grow without sacrificing the coordinated, high-accountability care that defines the model. When implemented effectively, these capabilities reinforce clinical excellence, care alignment, financial sustainability, and regulatory compliance that programs need at every stage of growth.

By reinforcing interdisciplinary teams with the right infrastructure, we can ensure that this era of expansion leads to a permanent, sustainable shift in how we care for our most vulnerable populations.