CMS is testing an alternative payment model for dementia services
The GUIDE model is to support people with Medicare living with dementia and their unpaid caregivers.
Photo: Westend61/Getty Images
The Centers for Medicare and Medicaid Services is testing an alternative payment model for providers who deliver supportive services to people with dementia. This includes comprehensive, person-centered assessments and care plans, care coordination, and 24/7 access to a support line.
Under the Guiding an Improved Dementia Experience (GUIDE) Model, people with dementia and their caregivers will have access to a care navigator who will help them access services and supports, including clinical services and nonclinical services such as meals and transportation through community-based organizations.
WHY THIS MATTERS
CMS said the model is to support people with Medicare living with dementia and their unpaid caregivers.
It aims to improve the quality of life for people living with dementia, reduce strain on unpaid caregivers and help people remain in their homes and communities through a package of care coordination and management, caregiver education and support, and respite services, CMS said.
The GUIDE Model also supports the goal of advancing health equity for underserved communities. Black and Hispanic, and Asian American, Native Hawaiian and Pacific Islander populations have a higher prevalence of dementia, are less likely to receive a diagnosis and have more unmet needs. These populations are also more likely to experience high caregiving demands and spend more of their family assets on dementia care. By providing financial and technical assistance for developing new dementia-care programs targeted to underserved areas, this model aims to improve the health outcomes and caregiving experience of Black, Hispanic, and Asian Americans, Native Hawaiian and Pacific Islander individuals and their families through increased access to specialty dementia care.
The model will provide a link between the clinical healthcare system and community-based providers to help people with dementia and their caregivers access education and support, such as training programs on best practices for caring for a loved one living with dementia. Model participants will also help caregivers access respite services, which enable them to take temporary breaks from their caregiving responsibilities. Respite has been found to help caregivers continue to care for their loved ones at home, preventing or delaying the need for facility care.
CMS will release the application for GUIDE, a voluntary, nationwide model, this fall. Prior to the application release, interested organizations are encouraged to submit Letters of Intent to CMS by September 15. The model will run for eight years beginning July 1, 2024.
THE LARGER TREND
The model, which is designed to enhance access to the assistance and resources caregivers need, is a key priority of the Biden-Harris Administration and Goal 3 of the National Plan: Expand Supports for People with Alzheimer's Disease and Related Dementias and Their Families, CMS said.
Evidence-based models of support for caregivers of people with dementia and dementia-capable community-based providers have been expanded over the last decade through investments in research and services by the Department of Health and Human Services and others.
The GUIDE Model is delivers on President Biden's April 2023 Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers, as well as key goals of the National Plan to Address Alzheimer's Disease.
ON THE RECORD
"While we have made tremendous progress in improving care for people with dementia through the National Plan to Address Alzheimer's Disease, people living with dementia and their caregivers too often struggle to manage their healthcare and connect with key supports that can allow them to remain in their homes and communities. Fragmented care contributes to the mental and physical health strain of caring for someone with dementia, as well as the substantial financial burden," said CMS Administrator Chiquita Brooks-LaSure.
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
