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CMS Announces New Medicare Dementia Model

The GUIDE Model Enhances Care Coordination and Increases Support for Caregivers

Aug 2, 2023 In a move to advance the care and support for individuals with Medicare living with dementia, the Biden-Harris Administration has announced a new Guiding an Improved Dementia Experience (GUIDE) Model. This innovative approach seeks to improve the overall well-being of people dealing with dementia and extend assistance to their unpaid caregivers. Let’s take a closer look at how this model is aimed at transforming Dementia care. 

The GUIDE Model was developed by the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS). It is designed to enhance the quality of life for dementia patients, lighten the burden on unpaid caregivers, and facilitate a stay-at-home environment through enhanced care management and coordination, caregiver support, and respite services.

Xavier Becerra, HHS Secretary, praised this step, “HHS continues to innovate to help Americans living with dementia and their unpaid caregivers. Our new GUIDE Model has the potential to improve the quality of life for people with dementia and alleviate the significant strain on our families,” said HHS Secretary Xavier Becerra. “We are proud to take these steps to deliver on the President’s promise to increase care coordination and improve access to services and supports for our families.”   

Why the focus on dementia care? Simply put, the challenges it presents often lead to fragmented care. This contributes to physical and mental strain for both patients and caregivers. It also brings significant financial stress.

This is where CMS Administrator Chiquita Brooks-LaSure steps in with the GUIDE Model. By offering comprehensive assessments and care plans, personalized care coordination, and around-the-clock support lines, this model intends to bridge gaps and unify care. The person at the center of this plan, a care navigator, will facilitate access to both clinical and non-clinical services, such as transportation and meal provisions.

“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 health care 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.”

What’s unique about the GUIDE Model is that it is more than a patient-centered model. It recognizes the invaluable role of caregivers, providing them with access to resources and assistance. The plan includes tailored training programs to help caregivers in their daily tasks and connects them to community-based providers for essential support. In addition, caregivers can obtain respite services, which provide temporary but much needed breaks. Studies have shown this improves home caregiving, which is turn improves patient care and satisfaction.

Another defining feature of the GUIDE Model is its commitment to health equity. It recognizes the unique needs of underserved communities, including Black, Hispanic, and Asian Americans, Native Hawaiian, and Pacific Islander populations. The model is crafted to enhance the healthcare outcomes and caregiving experiences of these individuals through more accessible specialty dementia care.

This nationwide model will commence on July 1, 2024, and run for eight years. There is an application release planned for Fall 2023, but interested organizations can express their intent by submitting a letter to CMS by September 15, 2023.

For additional information, click here to access the GUIDE Model Fact Sheet developed by CMS. You can also visit the GUIDE Model webpage.

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