According to the Centers for Medicare and Medicaid Services (CMS), dementia affected more than 6.7 million Americans in 2023, with 14 million projected cases by 2060. Despite these numbers, people living with dementia experience high rates of hospitalization and emergency department visits, as well as poor care management, that lead to poor health outcomes. Caregivers of patients with dementia are also impacted by poor outcomes brought about by depression and stress associated with their roles, which negatively affects their health.
In recognition of this gap in care and support, CMS launched the GUIDE Model on July 1, 2024. The Guiding an Improved Dementia Experience (GUIDE) Model is a voluntary nationwide, eight-year model focused on comprehensive, coordinated dementia care and improving quality of life for people with dementia and their caregivers. By setting a standard approach to care, GUIDE will enable those living with dementia to remain at home and a part of their community, while easing the burden on caregivers.
The GUIDE Model aims to address the key drivers of poor-quality dementia care in five ways:
- Defining a standardized approach to dementia care delivery for model participants. This includes staffing considerations, services for people with dementia and their unpaid caregivers, and quality standards.
- Providing an alternative payment methodology to model participants. CMS provides a monthly per-beneficiary payment to support a team-based, collaborative, and coordinated care approach. Under the model, participants will assign people with dementia and their caregivers to a Care Navigator who will help them access GUIDE services and supports, and non-GUIDE services and supports including clinical services and non-clinical services such as meals and transportation through community-based organizations.
- Addressing unpaid caregiver needs. Model participants are required to provide caregiver evidence-based education and support, including 24/7 access to a support line and training programs on best practices for caring for a loved one with dementia.
- Respite services. CMS pays model participants for respite services, which are temporary services provided to a beneficiary for the purpose of giving their unpaid caregiver breaks from their caregiving responsibilities.
- Screening for health-related social needs. Model participants are required to screen beneficiaries for psychosocial needs and health-related social needs (HRSNs) and help navigate them to local, community-based organizations to address these needs.
Health equity is also a critical aspect of the GUIDE model; families of those living with dementia face significant financial, emotional, and operational burdens, and these are often exacerbated for certain racial and ethnic groups, such as Black and Hispanic families. As such, GUIDE focuses on delivering equitable care and addressing health disparities in dementia. In addition, CMS actively sought out eligible organizations providing care to underserved communities for participation in the GUIDE Model.
The model features two tracks for Dementia Care Programs (DCPs). The first is aimed at established programs with experience serving dementia patients and that meet most GUIDE care delivery requirements already. These participants began delivering GUIDE services on July 1. The second track is for participants new to dementia care who will have a one-year pre-implementation period to establish their programs. This period began on July 1 with implementation beginning the following year on July 1, 2025. For more information, CMS published a blog post on the GUIDE Model. On July 8, 2024, CMS announced the 390 organizations are participating in the model. C-TAC members participating in GUIDE are listed below.
- Aging & In-Home Services of Northeast Indiana, Inc.
- Alivia Care Solutions, Inc
- Androscoggin Home Health Services, Inc. – Andwell Health Partners
- Avow Care Services, Inc.
- Care Dimensions, Inc.
- Cedars-Sinai Medical Center
- Gilchrist Hospice Care Inc
- Hospice of the Western Reserve, Inc.
- Housecall Providers Services PC
- Ochsner Clinic Foundation OBA Ochsner Medical Center
- Sutter Bay Medical Foundation
- Sutter Valley Medical Foundation
As these organizations design and implement their programs, C-TAC will be watching closely to see if this promising model can deliver better access to comprehensive dementia care and holistic support for caregivers for hundreds of thousands nationwide.
