Illinois: Implementing PACE in One of the Nation’s Most Complex Medicaid Environments

As states seek ways to expand community-based care for older adults, the Program of All-Inclusive Care for the Elderly (PACE) has emerged as one of the most effective models for coordinating medical and long-term services while supporting aging in place. Implementing the model successfully, however, requires thoughtful planning and careful integration with each state’s Medicaid program. Today, Illinois is building a growing number of PACE centers designed to serve older adults across both metropolitan areas and smaller regional communities.

Key Challenges

Illinois operates one of the largest and most complex Medicaid programs in the US, serving a diverse population across major cities, towns, and rural communities. As the state explored expanding options for older adults who qualify for nursing facility level of care, leaders recognized the opportunity for PACE to strengthen its long-term services and supports (LTSS) strategy while helping older adults remain in their homes and communities. To implement the model effectively, Illinois needed a structured approach to development, the establishment of an infrastructure that supports the delivery of high-quality care, and a strategic way to position the program for long-term growth.

Introducing PACE into a large Medicaid environment requires more than simply adding a benefit to the state plan. States must establish policy frameworks, procurement strategies, oversight processes, and operational infrastructures that allow the program to grow effectively. Equally important is the development of a strong data foundation that enables the state to monitor performance, evaluate outcomes, and make informed decisions about the program’s future direction.

Implementation Strategy

Working with the Illinois Department of Healthcare and Family Services, Myers and Stauffer supported the development and implementation of the state’s PACE program. The work focused on building a strong foundation for the program while positioning it for thoughtful and sustainable growth.

Key elements of the implementation effort included:

Supporting the development of state policy and operational frameworks.
Supporting data-informed planning to design community-appropriate service areas capable of sustaining successful PACE organizations.
Supporting procurement and program selection processes for PACE organizations.
Establishing oversight and monitoring structures to ensure program accountability and quality.
Assisting Illinois with onboarding oversight of PACE organizations and completing State readiness reviews.

Through this collaborative effort, Illinois introduced PACE in a way that balanced quality with strong program oversight while positioning the model for future success.

Results

Illinois officially added PACE to its Medicaid State Plan with an effective date of June 1, 2024, marking a significant milestone in the state’s LTSS strategy. Since implementation, the program has begun expanding access to coordinated care for older adults who wish to remain in their homes and communities while receiving comprehensive services tailored to their needs.

As Illinois approaches its two-year anniversary with PACE, enrollment is approaching 200 participants across four service areas. In 2026 and 2027 the program plans continued growth, including two additional service areas.

Illinois’ early experience with PACE demonstrates how states can successfully introduce the model within a large and diverse Medicaid environment. With a strong foundation in place, the state is well-positioned to expand access to coordinated, community-based care for older adults for years ahead. The Illinois experience also highlights the importance of thoughtful program design, strong state leadership, and effective collaboration between state agencies and implementation partners. Congratulations, Illinois HFS, on the two-year anniversary of PACE!