CMS to Test Alternative Payment Model for Dementia Care

Aug. 1, 2023
GUIDE care model designed to improve the quality of life for dementia patients and caregivers

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced its new dementia care model, which is intended to enhance the care and support for Medicare patients with dementia and their caregivers. The goals of the new care model are “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.”

The new model, titled Guiding an Improved Dementia Experience (GUIDE), will be tested by the CMS Innovation Center, and is a key part of a White House executive order on Increasing Access to High-Quality Care and Supporting Caregivers, as well as the National Plan to Address Alzheimer’s Disease

HHS Secretary, Xavier Becerra, said, “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.” 

CMS Administrator, Chiquita Brooks-LaSure, added, “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.” 

Through the GUIDE model, 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 non-clinical services such as meals and transportation through community-based organizations.” 

CMS Deputy Administrator and Innovation Center Director, Liz Fowler, said, “As millions of Americans already know, dementia can devastate people and their families in many ways. The GUIDE Model aims to mitigate the significant challenges of coordinating and managing health care and community-based supports and improve quality of life for patients and caregivers alike. By offering caregiver support, respite services, and improved access to community-based supports, the GUIDE Model aims to keep people living with dementia safer and in their homes longer.” 

In support of the GUIDE Model is Terry Fulmer, president of The John. A. Hartford Foundation, a New York City-based national philanthropy dedicated to improving the care of older adults. As a leader in the field of aging and health, the Foundation has three priority areas: creating age-friendly health systems, supporting family caregivers and improving serious illness and end-of-life care. 

“Comprehensive dementia care supports both the medical and non-medical needs of patients and their family caregivers. It’s age-friendly care that prioritizes the needs and preferences of the patient and their family members. We commend CMS for its diligence in advancing this model through which we can ensure that older persons with dementia and their families have a truly comprehensive and humane approach to care.” 

CMS will release the application for GUIDE in Fall 2023. Prior to the application release, interested organizations are encouraged to submit Letters of Intent to CMS by September 15, 2023. The model will run for eight years beginning July 1, 2024. More information can be found on the GUIDE Model Fact Sheet or at the GUIDE Model webpage.