With an ageing population, there is an increasing need to focus on the care of older adults, particularly those who are more medically complex. Frail older adults are more likely to require care from multiple providers across multiple settings. It is well recognized that the current Canadian healthcare system is not well-designed for this complex population. To address the health system challenges, healthcare leaders are rapidly developing and implementing programs to better support the ageing population. Unfortunately, this often means that organizations are implementing and scaling health and social care programs with limited evidence or understanding of the specific context in which it was implemented. Drawing on regional experiences, this article will explore challenges and offer solutions related to the implementation, spread, and scale of healthcare programs for older adults.