CA’s senior healthcare solution is hiding in plain sight

By Janice Grandy, Ph.D., especially for CalMatters

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You’ve probably never heard of PACE, but for thousands of seniors in California, it’s the reason they’re still living at home.

PACE stands for All Inclusive Program Care for the elderlyand it is an effective option for supporting older people whose goal is to age safely in their own homes. As a physician focused in the field of geriatric medicine (a specialty focused on the care of the elderly), I believe in the power of PACE. Unfortunately, it remains one of the most underutilized resources in our long-term care system. While there are several reasons for this, there are also several achievable solutions.

Each PACE program is community-based and provides comprehensive medical and social services. The goal is simple but powerful: help seniors age with dignity and independence while remaining in their communities as long as possible while reducing hospitalizations.

Its comprehensive services range from primary care, physiotherapy, social work and dentistry to transport, meals, home care and day center activities.

Some may think that PACE seems too good to be true, that it should only be available to those with sufficient resources. Well, good news! PACE is funded through Medicare and Medi-Cal, making it a feasible option for a wide range of people. Participants are eligible to enroll in PACE if they are age 55 or older, live in the PACE program service area, and require nursing home-level care.

PACE sounds good, but does it really work? A 2021 study by CalPACE, the state PACE advocacy association, found that PACE participants are hospitalized 44% less often than similar non-PACE individuals and had 26% less emergency department use. Additionally, 98% of PACE participants continued to live in the communityand participants are generally experienced lower levels of depressionbetter adherence to treatment and higher satisfaction with care.

PACE isn’t just the right thing for seniors; it’s smart public policy. As Medi-Cal costs rise and nursing home capacity is strained, PACE eases the strain on the senior care system and budget. For example, PACE enrollment saved California taxpayers $369.4 million only in 2024

Why then are they only about 10% of eligible adults are enrolled in PACE?

Unfortunately, PACE remains limited by geography, infrastructure and awareness. So far, PACE serves less than half of California’s counties. And starting a PACE program requires a significant upfront investment and navigating complex state and federal licensing processes.

Even where programs exist, many eligible seniors, caregivers, and health care providers are unaware of them. To improve access and utilization, we should consider focusing funding at the state level to help launch new PACE programs—especially in underserved areas—and on streamlining the approval process for PACE centers and investing in outreach to families, caregivers, and health professionals.

With almost one in four Californians expected to be aged over 60 by 2030, it is time to take action and invest in more effective and compassionate models of care.

Models like PACE hold hope for a future where every adult can age with the support, grace and respect they deserve.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.