According to the Alzheimer’s Association, more than 6 million Americans age 65 and older are living with dementia. The physical, emotional and financial toll on patients and caregivers is tremendous. Plus, many people with dementia do not consistently receive high-quality, coordinated care due to economics, where they live and other factors.
To address the inequities and test an alternative path to paying for and delivering better-coordinated care, in 2024 the Centers for Medicare and Medicaid Services (CMS) launched the Guiding an Improved Dementia Experience (GUIDE) Model. The model should reduce Medicare and Medicaid expenditures by helping people with dementia remain at home and out of hospitals, emergency rooms and long-term nursing homes.
A GUIDE Model-assigned Care Navigator will coordinate with patients and caregivers (for free) to offer:
- 24/7 support line access
- Caregiver training & education
- Caregiver support services, including respite services
- non-GUIDE services and supports including clinical services and non-clinical services such as meals and transportation through community-based organizations
For a helpful snapshot of GUIDE services, view here.
To qualify, beneficiaries must be enrolled in Medicare Parts A and B as their primary payer and have been diagnosed with dementia by a clinician. They may not be enrolled in a Medicare hospice benefit or living in a long-term nursing care facility. The Guide Model care is not available with Medicare Advantage. Though the pilot is small, there are several participating providers in Connecticut and the number is expected to grow as the model proves its value. Stay tuned!
Source: CMS.gov