Medicare Dementia Care Model Is Established by HHS

The Guiding an Improved Dementia Experience (GUIDE) Model, which 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 has been established by the U.S. Department of Health and Human Services.

Through the GUIDE Model, the Centers for Medicare and Medicaid Services (CMS) will test an alternative payment for participants who deliver key supportive services to people with dementia, including comprehensive, person-centered assessments and care plans, care coordination and 24/7 access to a support line. Under the 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.

The model is also designed to enhance access to the assistance and resources caregivers need. 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 HHS and others. 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.

“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. “We know that Black, Hispanic and Asian Americans, Native Hawaiian and Pacific Islander populations have been particularly disadvantaged in receiving dementia care. The GUIDE Model will provide new resources and greater access to specialty dementia care in underserved populations and communities.”