Many Medicare beneficiaries could benefit from a model like Program of All-Inclusive Care for the Elderly (PACE) that offers comprehensive Medicare and Medicaid benefits to frail, older adults who want to remain living in the community. However, many older adults on Medicare do not have Medicaid coverage, making PACE less affordable to them.
This Tip Sheet discusses various PACE-adjacent pathways for PACE organizations to consider exploring to serve Medicare-only individuals. ATI supports PACE program growth and diversification.
Recent Work
PACE Growth by the Numbers: October 2026
Program of All-Inclusive Care for the Elderly (PACE) is a capitated health plan that provides comprehensive Medicare and Medicaid covered services to frail, older adults in the community who are eligible for nursing home care. New research from ATI explores the latest enrollment trends and highlights latest opportunities for PACE growth.
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A Practical Option for States: One-Time Medicaid Reassignment to Support D-SNP Alignment
Beginning January 1, 2030, Dual Eligible Special Needs Plan (D-SNP) enrollment must be fully aligned with Medicaid plan enrollment, and beneficiaries will no longer be able to stay in their current D-SNP. Building on a previous ATI resource, this brief outlines a transitional strategy for states subject to the impending D-SNP enrollment alignment requirements to consider.
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The Kim Frailty Index and Implications for LEAD ACOs
The Kim Frailty Index (KFI) is a validated, peer-reviewed measure of frailty that uses only healthcare claims data to measure frailty with sufficient accuracy for population-level decision making. The CMS Innovation Center is embedding KFI data into its Long-term Enhanced ACO Design (LEAD) Model as one of the factors used to assess whether a beneficiary qualifies as "High Needs."
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