Program of All-Inclusive Care for the Elderly

What is PACE?

PACE stands for Program of All-inclusive Care for the Elderly. It is an innovative Medicare program that provides frail people age 55 and older comprehensive medical and social services coordinated and provided by an interdisciplinary team of professionals. The services are provided in a community-based center and in participants' homes, helping them delay or avoid long-term nursing home care.

Each participant receives customized care that is planned and delivered by a coordinated, interdisciplinary team of professionals working at the center. The team meets regularly with each participant and his or her representative to assess their needs. A participant's care plan usually integrates some home care services from the team with several visits each week to the PACE center, which serves as the hub for medical care, rehabilitation, social activities, and dining.

The PACE model was developed in San Francisco in the 1970s as ON LOK, the Chinese American community’s alternative to nursing home placement. It was formally established by CMS as a permanent Medicare Advantage option in 1997.

Who is eligible to participate in PACE?

To participate in PACE, a person must be:

• 55 years of age or older. 
• Require nursing home level of care but be able to live safely in the community at the time of enrollment with the services of PACE.
• Reside in the service area of a PACE organization. 

PACE participants may disenroll from the program at any time and for any reason, and those with Medicare or Medicaid who disenroll will be assisted in returning to their former healthcare coverage.

What services are provided through PACE?

PACE provides its participants with all services covered by Medicare and Medicaid, without the limitations normally imposed by these programs. It also provides any other services deemed necessary by the interdisciplinary team that would allow program participants to remain in the community. 

Services provided by PACE include, but are not limited to, 

• Primary care (including doctor, dental and nursing services)
• Prescription drugs
• Adult day health care
• Home and personal care services
• Nutrition services
• Hospital and nursing home care (if and when needed)
• Transportation to and from the center and all off-site medical appointments is also provided

Who pays for PACE?

PACE organizations receive a set amount of Medicare and Medicaid funds each month to ensure participant care, whether services are provided in the home, community or in a nursing home setting. This capitated funding arrangement rewards providers who are flexible and creative in providing high quality care and gives them the ability to coordinate care across settings and medical disciplines. The program also accepts participants who pay privately.

Is PACE available in my community?

DSHS currently contracts with Providence PACE, International Community Health Services and PNW PACE Partners to administer the PACE program. There are nine PACE centers in Washington state. 

You must live in their coverage area to participate. See PACE Coverage Area Zip Codes (xls)

How do I get more information on PACE?

For information on the PACE program and enrollment, contact:

• Providence PACE intake at (206) 320-5325 or online
• ICHS PACE at (206) 462-7100 or online
• PNW PACE Partners at (253) 459-7270 or online

For Washington State policy and contract information, contact:

• Email: PACE@dshs.wa.gov.

Additional information can also be found on the National PACE Association website or the CMS website.

How do I become a PACE contractor in Washington?

Organizations should understand and complete the following general steps presented in the “How do I become a PACE contractor in Washington” found below.

All current WA PACE entities seeking to expand, either into an existing county service area or into a new county, must submit the following:

• Letter of Intent – see below
• Map of Service area
• Market feasibility study – see below

How do I become a PACE contractor in Washington?

• Potential organization researches Federal regulations and information available from the National PACE Association to assess the feasibility of becoming a PACE organization. 
• Any entity seeking to become a PACE organization in Washington may contact HCLA at PACE@dshs.wa.gov regarding state-specific requirements. 
• Review the “WA State Counties List” for counties open to PACE expansion inquiries. 
• Research into whether an existing potential organization is already providing PACE in a service area of interest. 
• Potential organization completes a feasibility study which includes providing evidence that the PACE organization will either be cost neutral or save money for long-term care services provided by the State in the service area.
• Potential organization submits a letter of intent and the feasibility study to HCLA PACE Program Manager at PACE@dshs.wa.gov. 
• HCLA will review letter of intent and feasibility study and provide confirmation of acceptance or denial of letter of intent.
• If letter of intent is approved by HCLA, Potential organization prepares and submits a PACE application to HCLA. 
• HCLA contacts CMS Central Office to notify them of the possible addition of PACE sites. 
• HCLA evaluates the organization and approves the application as appropriate. 
• The potential organization submits the formal application to CMS with the HCLA assurance that the entity is considered to be qualified as a PACE organization and is willing to enter into a PACE organization agreement with the entity. 
• Readiness Review occurs with an HCLA site visit. 
• Within 90 days of formal application, CMS approves, denies, or requests additional information.
• It may take up to two years to complete the process to become a PACE organization. 
• Once CMS approves, the PACE organization enters into a three-party agreement with the CMS, and the Washington HCLA. 
• The PACE organization contracts with HCLA and proceeds to enroll beneficiaries

 

WA State Counties List (9/2026)

County	Open
Adams	Yes
Asotin	Yes
Benton	No
Chelan	Yes
Clallam	Yes
Clark	Yes
Columbia	Yes
Cowlitz	Yes
Douglas	Yes
Ferry	Yes
Franklin	No
Garfield	Yes
Grant	Yes
Grays Harbor	Yes
Island	Yes
Jefferson	Yes
King	No
Kitsap	Yes
Kittitas	Yes
Klickitat	Yes
Lewis	Yes
Lincoln	Yes
Mason	No
Okanogan	Yes
Pacific	Yes
Pend Oreille	Yes
Pierce	Yes
San Juan	Yes
Skagit	No
Skamania	Yes
Snohomish	No
Spokane	No
Stevens	Yes
Thurston	Yes
Wahkiakum	Yes
Wahkiakum	No
Whatcom	No
Whitman	Yes
Yakima	No

 

Letter of Intent

All applicants must submit a letter of intent to HCLA indicating their plans to submit a PACE application. 

The letter of intent should identify:

• Confirmation of intent to bring PACE services to a service area in Washington state and submit a CMS PACE application.
• Identification of the applicant.
• Proposed service area including zip codes.
• Proposed site location for the applicant's PACE center.
• Confirmation of capital and infrastructure to support PACE operations.
• New applicants proposing to serve an area with an existing or pending PACE organization must identify the overlapping zip codes in their letter of intent.
• Letter of intent must state the timeline related to CMS application activity which needs to occur no later than two (2) years upon receipt and acceptance of letter of intent request.

 

Market Feasibility Study

All PACE applicants must submit a market analysis of the area that they propose to serve. 

The feasibility study should include the following: 

• Estimate of the number of potential PACE eligible people in proposed service area, utilizing the most recent potential PACE eligible report.
• Demonstrate understanding of timeline for implementation.
• Description of the methodology/assumptions used to determine potential membership.
• Identify all competitive factors impacting the market (Existing POs, managed care/Medicare advantage plans, ACOs or other demonstrations and long-term care programs).
• Identify projected market capture/saturation rate.
• Demonstrate that there is an unmet need for PACE in the proposed service area.

 

HCLA PACE Service Area Policy

Download HCLA PACE Service Area Policy (PDF)

 

PACE Contract Model

Download PACE Contract Model (PDF)

 

PACE WACs

View PACE WACs