Improving Your PACE Enrollment Process At Scale
The old adage, “what got you here, won’t get you there,” certainly holds up in PACE. For smaller PACE providers operating in a single center, enrollment often works because of the people running it. An intake coordinator knows every discharge planner by name. The enrollment lead walks down the hall to check on an assessment. Handoffs happen in conversation, and problems get caught because someone remembers. That isn’t a flaw. It’s how most programs reach their first census targets.
Growth changes that. A second center, an expanded service area, or a new market adds a lot of volume to referral, intake, assessment, and enrollment. The informal systems that held everything together stay the same size, which creates natural constraints and bottlenecks that are nobody’s fault.
Relationships stop scaling with people
In a single-center program, referral relationships tend to belong to individuals. When the program expands, those same few people are suddenly expected to cover twice the territory. Referral sources in the new market get less attention, and existing ones start to drift. Growth requires referral management that lives in a system, not in someone’s contact list.
Handoffs multiply
More centers mean more people touch each candidate. This includes from functions like centralized intake, site-level enrollment staff, and interdisciplinary team members scheduling assessments across locations. Every added handoff is another point where a qualified candidate can stall. Ownership at each stage needs to be explicit, documented, and visible to everyone, including those who need to understand how many new participants will need to be onboarded that month.
Assessment capacity becomes the constraint
Referral volume can scale quickly, but assessment capacity usually doesn’t. Programs that grow referrals without planning for IDT availability at each site often leave candidates waiting weeks for an assessment slot. That wait is where engaged families quietly go elsewhere. When families turn to PACE, it’s often because they’ve reached a crisis point, and every delay makes it more likely they will choose another option not because they’ve rejected the PACE model, but because they don’t have a choice.
Visibility has to come from data, not memory
At one center, the enrollment manager can usually tell you where things stand. Across several, leadership needs that same answer without a round of phone calls. That requires every site to define funnel stages the same way. It also requires reporting that shows where each candidate is and how long they’ve been there. That time-in-stage is a critical KPI that is not tracked often enough, and provides true visibility into the efficiency of the intake process.
Consistency matters more than any single tactic
Every site will want to do things its own way. Some local adaptation makes sense. But when intake scripts, follow-up timing, and stage definitions differ by center, comparisons fall apart and what works in one place can’t spread to the others. A shared process gives each new center a running start instead of a blank page.
The programs that scale enrollment well don’t necessarily have more staff or bigger outreach budgets. They recognized early that a team got them to their first full census, and a system will get them to the next one. The time to build that system is before an expansion event or edict, not after the first soft enrollment month.