Focusing on the original programme of On Lok operating in one area of the USA, this case study examines the Program of All-Inclusive Care for the Elderly (PACE) model of care and explores the potential for the model to be adapted for use with a wider population. The PACE model serves a target population of people age 55 and older, who need long-term care but are able to safely live at home. Key features of the programme include: comprehensive medical and social services delivered in community day centres and people’s homes; care coordination by interdisciplinary teams, and integrated care through to end of life. The service promotes socialisation, activity, and independence, while lessening burden on family caregivers. Evaluation estimates that the service improves some aspects of care quality and reduces need for acute care, while achieving costs comparable to traditional Medicare. Challenges identified include that it is operationally complex and also requires large care teams. It also may need some adaptation to reach larger share of population. This is one of a series of case studies examining programs in the United States that aim to improve outcomes and reduce costs of care for patients with complex needs.