New Federal Study Confirms PACE Outperforms Other Integrated Care Options

New Research Shows PACE Participants Have Significantly Lower Rates of Hospitalization, Emergency Room Use and Death

WASHINGTON, DC – June 8, 2026 – A new study led by the U.S. Department of Health and Human Services (HHS) and conducted by RTI International confirms that the Program of All-Inclusive Care for the Elderly (PACE) delivers superior health outcomes for dually eligible seniors compared to those not enrolled in integrated options, as well as in comparison to other integrated Medicare and Medicaid health plan options.

The study, titled Integrated Care and Health Outcomes for Dual Eligible Individuals, analyzed the Medicare data of 3 million dually eligible beneficiaries in 2021. Dually eligible individuals are enrolled in both Medicare and Medicaid and are among the costliest and most medically complex people in the country.

Using rigorous propensity score matching to ensure an apples-to-apples comparison, researchers found that PACE participants were significantly less likely to be hospitalized, significantly less likely to visit an emergency room, and significantly less likely to die than comparable enrollees in non-integrated Medicare Advantage (MA) plans. These advantages held even after controlling for age, health status, and the fact that PACE serves older, frailer participants than other plan types.

Despite these outcomes, only 4 percent of eligible older adults currently have access to a PACE program.

PACE, the only care delivery model that fully integrates Medicare and Medicaid financing under capitated payments, serves seniors age 55 and over who are certified as needing a nursing home level of care. Rather than placing these individuals in institutions, PACE coordinates all of their medical, behavioral and long-term care needs through an interdisciplinary team, enabling them to remain living safely in their homes and communities.

"This study makes it impossible to ignore what the evidence has been telling us for decades: PACE works," said Shawn Bloom, president and CEO of the National PACE Association (NPA). "PACE expansion enjoys broad support because it is cost-effective for taxpayers and families. An alternative to nursing home care, it provides seniors with an opportunity to remain safely independent while reducing the strain on families and caregivers to deliver a better quality of life. Today's findings are a call to action – not just to protect PACE, but to dramatically expand it so that every eligible American who needs this level of care can access it."

The Evidence Is Clear, and the Gap Is Striking

The study findings establish a clear performance hierarchy among integrated care models:

• PACE participants were significantly less likely to be hospitalized than comparable MA enrollees.
• PACE participants had significantly lower emergency department use, while D-SNP and FIDE-SNP enrollees showed higher rates than the comparison group.
• PACE participants were significantly less likely to die within the year, a finding that proved statistically significant for the first time using the improved methodology of the study.
• Institutional use – primarily nursing home stays – was lower among PACE participants than in the comparison group, though that difference did not reach statistical significance. That was likely because the matched comparison group was restricted to users of home- and community-based services (HCBS) with nursing home level-of-care needs, making the groups highly similar in baseline risk.

The authors attribute the superior performance of PACE to its fully integrated, team-based care model – the only approach in which a single organization holds comprehensive accountability for both Medicare and Medicaid services, with no gaps in coordination and no financial incentive to shift costs between payers.

A Moment of Bipartisan Urgency

The release of this study comes as Congress and the administration grapple with the long-term care financing crisis facing 12 million Americans who need long-term services and supports, a number projected to grow dramatically as the baby boom generation ages. Policy-makers in both parties are searching for care models that reduce unnecessary spending without cutting services to vulnerable people.

CMS administrator Mehmet Oz, MD, who delivered the keynote address at the NPA Spring Policy Forum in March, has publicly recognized the essential role of PACE organizations in delivering high-quality, community-based care for the aging population. The RTI study provides the most rigorous evidence to date supporting the expansion that Dr. Oz and NPA have called for.

Despite its proven track record, PACE faces significant regulatory barriers that constrain growth: enrollment is limited to the first of the month, organizations may submit only one expansion application at a time, and state-level enrollment caps restrict access in at least 10 states. NPA is urging CMS and Congress to remove these barriers, which would enable the PACE infrastructure to meet the moment.

For More Information

The study on Integrated Care and Health Outcomes for Dual Eligible Individuals was prepared by RTI International for the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE), Office of Behavioral Health, Disability and Aging Policy. The study was completed on Oct. 9, 2025, and published on March 27, 2026.

PACE is a person-centered, provider-led integrated care model that enables older adults with complex chronic care needs to live safely in their homes and communities. PACE provides all needed medical, behavioral and long-term care services through an interdisciplinary team. Today, more than 200 PACE organizations serve 94,500 seniors across 33 states and the District of Columbia.

NPA works to advance the efforts of PACE programs. Its mission is to provide leadership and support for the growth, innovation, quality and success of the PACE model of care. Follow NPA on social media.