Details Emerge About Participants in Dementia Alternative Payment Model

July 9, 2024
CMS Innovation Center launches the GUIDE Model, with 390 participating organizations building dementia care programs

On July 1, the Centers for Medicare & Medicaid Services (CMS) Innovation Center launched the Guiding an Improved Dementia Experience (GUIDE) Model, with 390 participating organizations building dementia care programs that will serve hundreds of thousands of people with Medicare nationwide.

CMS said the GUIDE Model, which will run for eight years, will be one of the first Innovation Center care models to focus on longitudinal, condition-specific comprehensive care, a key element of the Innovation Center’s 2022 Specialty Strategy. Today, nearly 7 million Americans live with Alzheimer’s disease or another form of dementia, and, by 2060 the number of Americans living with dementia is expected to double to 14 million.

Details about many of the model participants are starting to emerge. Participants represent a wide range of healthcare providers, including large academic medical centers, small group practices, community-based organizations, health systems, hospice agencies, and other practices.

UConn Health in Connecticut shared details about how its program is set up. Patients eligible for the pilot program at UConn Health are those who visit with a UConn Center on Aging geriatrician and have a diagnosis of dementia. UConn Health will be proactively contacting its patients who may be eligible for the program, along with CMS. The UConn Center on Aging  geriatricians will also accept new patients into the GUIDE Model Program.

Patients enrolled in the GUIDE program will receive a comprehensive assessment by UConn Health geriatricians and a home visit from a UConn Health navigator to identify any at home safety risks and needs. The multidisciplinary care team at UConn Health will also work with caregivers to develop a coordinated care plan and medication schedule and provide caregiver skills training, and referrals to helpful services such as home-delivered meals and transportation, along with 24/7 access to their UConn Health GUIDE care team’s phone support line. Access to respite services will be available so caregivers have time to care for themselves, too.

“This program will allow UConn Health to provide vital care coordination services to address social, environmental, and emotional concerns and help people living with dementia remain in their own homes, said Khadija Poitras-Rhea, L.C.S.W., associate vice president of population health at UConn Health, in a statement. “GUIDE combines comprehensive medical care for patients with additional services like support groups, respite care, community resources and education to support person-centered care. The program has a focus on health equity and our team will work closely with senior centers, faith communities and others in underserved areas to offer the benefits of GUIDE  to help reduce health disparities when it comes to memory care for marginalized groups and promote greater health equity.”

Emory Integrated Memory Care in Atlanta is participating in GUIDE. A joint initiative between the Emory University Nell Hodgson Woodruff School of Nursing and Emory Healthcare, Emory Integrated Memory Care offers geriatric primary care, dementia care, and caregiver education and support. The nurse-managed practice is available as an outpatient clinic at the Emory Brain Health Center in Brookhaven and at select Atlanta-area senior living communities.

Emory Integrated Memory Care is the only primary care practice in the U.S. specifically designed for people living with dementia and their care partners. The practice operates under the management of nurse practitioners with advanced training and specialization in dementia, geriatrics and palliative care.

Among the GUIDE participants are virtual care providers. The CareAtHome Medical Group, a national independent medical group that provides clinical care via telemedicine to patients with chronic conditions and home-based care needs, is partnering with Vesta Healthcare, a healthcare services organization and its network of home-based care providers to deliver the GUIDE program in 11 states. 

“CMS is excited to partner with CareAtHome and Vesta Healthcare under the GUIDE Model,” said CMS Administrator Chiquita Brooks-LaSure, in a statement. “GUIDE is a new approach to how Medicare will pay for the care of people living with dementia. The GUIDE participants are envisioning new ways to support not only people living with dementia but also to reduce strain on the people who care for them so that more Americans can remain in their homes and communities, rather than in institutions.” 

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