As Medicaid budgets tighten, states are looking for ways to better serve dually eligible individuals whose complex needs and high care costs may not be adequately addressed by more prevalent integrated care models. The Program of All-Inclusive Care for the Elderly (PACE) offers a highly integrated approach for this population, yet despite substantial enrollment growth in the last decade, PACE serves only one percent of the nation’s more than nine million full-benefit dually eligible individuals.

To understand opportunities to expand access to PACE, the Center for Health Care Strategies and the National PACE Association convened national experts, state regulators, PACE organizations, researchers, and funders in October 2025. This meeting summary highlights barriers and priority actions identified by convening participants across four key areas: reducing administrative and financial burdens to start or expand PACE organizations; expanding enrollment and eligibility; measuring and messaging quality; and enhancing workforce and operational flexibility. The summary, developed with support from The John A. Hartford Foundation, is designed to inform states, policymakers, and other stakeholders seeking to expand access to PACE for older adults with the greatest needs.