People living with dementia often experience multiple chronic conditions, as well as high rates of hospitalization and emergency department visits, among other things. Caregivers of patients with dementia are also impacted by depression and stress associated with their roles, which negatively affects their health. The Centers for Medicare & Medicaid Services (CMS) recently released the Guiding an Improved Dementia Experience (GUIDE) Model to improve the quality of life of those living with dementia, while also hoping to ease the burden on caregivers! The GUIDE Model began July 1, 2024, and is scheduled to run for 8 years. Hopefully, if well-received and well -utilized, it will be continued by CMS after the 8-year trial period.

The GUIDE Model is a voluntary, nationwide, program for Medicare Part B providers that aims to improve the quality of life for people living with dementia, reduce the strain on unpaid caregivers, and help people remain in their homes and communities. It does so through assistance with care coordination and management, caregiver education and support, and respite services. This page has a GUIDE Providers Participant List in the right margin that is regularly updated as more providers join the program.

If you click the link for the Participant List, it will download the Excel spreadsheet to your computer, and you can then open it if you have Excel installed. You may need to click “enable editing,” and you can then scroll to the “State” column and click the down arrow to the right of the word “State” and you’ll see the option to sort alphabetically by states, or click the checkbox next to the default “Select All” to clear all selected states, and then scroll down to select just the state(s) you want to see.

 

 

Eligibility for the GUIDE Model

The GUIDE model features two tracks for Dementia Care Programs. The first is aimed at already established programs with experience serving dementia patients that meet GUIDE care delivery requirements, and the other involves developing new programs. People with Medicare must have dementia to be eligible for GUIDE participation and may be at any stage of dementia — mild, moderate, or severe. When a person with Medicare is first assessed for the GUIDE Model, CMS relies on a documented dementia diagnosis from a Medicare-enrolled practitioner. Medicare must be the participant’s primary payer, and participants cannot be enrolled if they are already residing in a nursing home.

The GUIDE Model aims to address the key drivers of poor-quality dementia care in these ways:

• Improve quality of life for people living with dementia by addressing their behavioral health and functional needs, coordinating their care for dementia and other co-occurring conditions, and improving transitions between community, hospital, and other medical settings.
• Delay long-term nursing home care for as long as appropriate by supporting caregivers and enabling people living with dementia to remain safely in their homes for as long as possible.
• 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.
  • They reduce burden and strain on unpaid caregivers of people living with dementia by providing caregiver skills training and referrals to community-based social services and supports.
  • 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 and help navigate them to local, community-based organizations to address these needs.
• Delivering equitable care and addressing health disparities in dementia. CMS actively sought out eligible organizations providing care to underserved communities for participation in the GUIDE Model.

To learn more about the GUIDE Model, visit the DementiaCareAware website here.