As Programs of All-Inclusive Care for the Elderly (PACE) continue to expand nationally, home-based care providers will play an increasingly central role in making the model work.

PACE is one of the most comprehensive—and complex—value-based care models in the country. It combines the functions of a health plan, primary care practice, adult day center, transportation provider, and home care agency, all under one umbrella. While outcomes are strong, launching a PACE program requires significant capital (often $10M+ per market), intense regulatory approval from the state, and the operational capacity to manage full risk for a clinically and socially complex population.

For Massachusetts, the implications are clear:

• Home care agencies will be essential partners. PACE programs rely heavily on in-home services to keep frail older adults stable, prevent hospitalization, and support end-of-life care at home.
• Competition for contracts will increase. As more health systems and managed care organizations invest in PACE, agencies that are organized, compliant, and able to demonstrate quality outcomes will be better positioned to secure preferred partnerships.
• Regulatory alignment matters. PACE operates under high regulatory oversight. Massachusetts agencies working with PACE entities will need strong documentation, workforce stability, and clinical coordination capacity.
• Behavioral health, pharmacy, and palliative integration are expanding. Modern PACE models are integrating more advanced geriatric and interdisciplinary approaches—creating opportunities for agencies with specialized capabilities.

PACE is not easy to build, and growth depends heavily on state approval. But where it works, outcomes for participants are strong—and demand for reliable home care partners grows with it.

The Alliance is exploring ways to make PACE collaboration more accessible for Massachusetts members. Agencies interested in shaping that effort are encouraged to join the working group.