What Happened When Burlington Tested the PACE Model?
- Feb 14
- 2 min read
In 2019, the Burlington Community Health Team piloted a community-based wellness hub inspired by the U.S. PACE (Program of All-Inclusive Care for the Elderly) model.
The goal was simple: support older adults with complex medical and social needs to live safely at home longer — while reducing avoidable strain on the health system.
The results were measurable. And meaningful.
A Community-Based Approach to Aging at Home
The Burlington Wellness Hub brought together a coordinated team to support older adults who were at higher risk of hospitalization or long-term care placement.
Instead of navigating multiple disconnected services, participants accessed integrated health and social supports through a coordinated model focused on prevention, connection, and continuity.
The approach emphasized:
Proactive, team-based support
Better coordination across providers
Faster response when needs changed
Support for social and emotional wellbeing
Key Outcomes From the Burlington Pilot
The pilot demonstrated measurable improvements for both participants and the health system:
24% fewer hospitalizations
35% fewer EMS calls
74% of participants felt less lonely
68% reported reduced anxiety or depression
These results highlight something important: when care is coordinated and community-based, people often feel better — and systems can work more effectively.
Why This Matters for Families and Communities
Canada’s population is aging, and more older adults are living with complex health conditions alongside challenges like mobility, isolation, and caregiver strain.
Too often, support is spread across multiple organizations and appointments — leaving families to coordinate on their own.
The Burlington pilot showed that when services are aligned around the person, outcomes can improve, and families can feel more supported.
A Proof of Concept for Canada
While the U.S. PACE model has decades of evidence behind it, the Burlington Wellness Hub helped demonstrate what a PACE-inspired approach can look like in Ontario.
It reinforced a few key ideas:
Aging at home is possible with the right supports
Integrated care improves experience and outcomes
Social connection is a health support — not an “extra”
Proactive coordination can reduce system strain
What Comes Next
PACE Canada builds on lessons from pilots like Burlington to support communities interested in coordinated, team-based models of care for older adults with complex needs.
This work is not about replacing existing providers. It’s about strengthening coordination, aligning supports, and making aging at home easier to navigate.
The Burlington story is an early example of what’s possible, and a reminder that coordinated care is more than an idea. It works.
Want to learn more about coordinated care in action? Explore PACE Canada’s projects or connect with us to discuss partnership opportunities.
Photo/Video Credit: Community Wellness Hub
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