How to Scale and Stay Compliant in the PACE Market

In the PACE market, enrollment is climbing, and funding continues to accelerate.

For many non-emergency medical transportation (NEMT) providers, scaling from 100 to 250 or more vehicles sounds excellent, but it’s not exactly simple. 

Growth brings new challenges in compliance, consistency, and cost control. Without the right systems in place, even experienced operators can struggle to maintain standards across multiple PACE centers.

However, with the right data systems, automation, and operational structure, high-performing NEMT providers can expand efficiently without sacrificing quality or compliance. 

This article examines how fast-paced NEMT providers can scale beyond 100+ vehicles, maintain compliance, and protect margins through more innovative systems without adding extra administrative burden.

Growth Opportunities in the PACE Market

According to the National PACE Associations (NPA), between September 2019 and December 2023, the number of PACE organizations increased by 19 percent, and PACE enrollment increased by 41%. 

In 2024 alone, 112 out of 155 existing programs increased enrollment, with an average growth rate of nearly 14%. For large NEMT operators, these stats signal a massive opportunity. 

As more seniors become eligible, and states issue new RFPs for PACE services, the addressable market widens. For larger providers under PACE contracts, the next step, with 250 or more vehicles, is capitalizing on a rising market wave. 

As new PACE centers come online, trip volume and service demand will compound, creating economies of scale for operators who can grow efficiently. Each new vehicle and route improves fleet utilization, spreads fixed costs, and strengthens bargaining power with payers and partners.

Common Risks of Scaling Under PACE

Rapid expansion often exposes weaknesses in operations that once felt solid.
As PACE fleets grow into multi-center operations, many leaders realize their existing systems can’t keep up. 

Often, transition reveals weak processes, inconsistent data, and manual systems that fail to keep pace with growth. 

Here are some of the biggest risks that large NEMT providers face:

Dispatch Inconsistency

Dispatching inconsistency is usually the first warning sign. 

What worked with one or two centers quickly splinters into disconnected systems, competing processes, and data silos. Without a unified system or shared performance dashboards, it is challenging to keep up with dispatching metrics. 

The cost of fragmentation often results in longer trip times, overlapping routes, and underutilized vehicles, which drain your productivity and profits.

Cost Inefficiencies

As your fleet expands, duplicated routes, half-filled vans, and overlapping service zones quietly eat away at margins.

As you grow with new PACE centers and multiple routes, overlaps can appear easily. 

These inefficiencies aren’t the result of poor management, but the result of limited visibility. Without a centralized system, local dispatchers make decisions that seem efficient in isolation but ultimately increase total costs for the fleet. 

When every decision is made with local data instead of systemwide insight, profitability slowly erodes.

None of these are isolated mistakes; they’re symptoms of scaling with outdated tools. 

Sustainable expansion requires a shift from manual coordination to data-driven orchestration. Dispatch, compliance, and cost management must operate from one unified system.

Growth isn’t about hiring more staff or adding more work to your team; it’s leveraging technology and new systems to gain control and consistency. 

Build a Scalable Foundation

As fleets cross the 100-vehicle mark, leadership evolves from managing operations to engineering scalability. 

Growth is built on systems that replicate consistency, visibility, and control across every center. This growth is dependent upon three pillars:

1. Automation

2. Centralized data

3. A disciplined multi-center strategy. 

Automation: Turning Repetition into Reliability. 

The most scalable PACE operations eliminate manual oversight and automate tasks that previously drained human bandwidth, including recurring scheduling, live GPS-based tracking, and performance reporting.

For dispatch, automation creates consistency. When every trip assignment, route update, and ETA adjustment follows the same logic, service levels remain uniform regardless of which center operates the route.

For compliance, automated license renewals, safety checks, and audit alerts eliminate manual workarounds and the burden of manual tasks.

This automation means less manual coordination and more predictable execution. 

Centralized Data: One Source of Truth

Fragmented data is the silent killer of operational efficiency. 

Centralizing trip, vehicle, and driver data gives leadership real-time visibility into KPIs, compliance, and costs.  When dispatch, maintenance, and billing all operate from the same dataset, decisions are faster, more accurate, and easier to audit.

Data centralization enables strategic control, reduces chaos, and creates immediate accountability across teams.

Multi-Center Strategy: Standardize to Scale, Flex to Win

No two PACE centers are identical; demographics, trip density, and state requirements all differ. 

However, scalable growth depends on a common operational backbone that is flexible and adaptable.

Leading NEMT providers deploy standardized workflows, KPIs, and training modules across all centers, while allowing local customization where it adds value. 

In short, sustainable growth creates a structure that makes every additional vehicle just as efficient and compliant as the first.

Operational Best Practices for Multi-Center Growth

As fleets expand, disciplined operations become the real differentiator. 

Scalable growth depends on consistent processes, shared visibility, and clear accountability across every PACE center. Here’s how larger NEMT providers can achieve that balance:

• Unify scheduling and dispatch: A single platform ensures consistent routing, live GPS tracking, and shared driver pools across sites.
• Standardize SOPs: Documented processes for scheduling, reporting, and onboarding keep every center aligned and audit-ready.
• Utilize shared KPI dashboards: Track on-time performance, cost per ride, and seat utilization in a single view for data-driven oversight.
• Assign local compliance owners: Each center maintains daily compliance, reporting into a centralized system for enterprise-wide control.
  
  

These practices turn expansion into predictable scaling, ensuring every new center contributes to consistent performance, sustainable margins, and operational clarity.

Technology as a Growth Multiplier

As fleets expand, technology becomes more essential. 

With platforms like Tobi, NEMT leaders can manage complexity across multiple PACE centers with precision and speed. 

Tobi’s centralized dashboards provide a clear view of every vehicle, route, and compliance metric. Automated scheduling and dispatching reduce manual workload, freeing dispatchers to focus on service quality instead of data entry.

PACE-ready compliance reporting keeps documentation audit-ready; no spreadsheets, no blind spots.

The impact is clear: faster decisions, lower administrative overhead, and fewer errors as operations scale.

Scaling PACE Smartly

Scaling PACE operations means building systems that make every new mile as efficient, compliant, and profitable as the first.

Providers who invest in automation, centralized data, and structured expansion will be the ones who scale sustainably, not just rapidly.

Ask yourself: Is your PACE operation built to last, or is it only designed to grow bigger?

If you’re ready to scale with confidence, book a demo and see how leading fleets use Tobi to turn complexity into control.