Draft:Guiding an Improved Dementia Experience (GUIDE) Model
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Last edited by Auric (talk | contribs) 13 hours ago. (Update) |
Comment: In accordance with the Wikimedia Foundation's Terms of Use, I disclose that I have been paid by my employer for my contributions to this article. Hottocare (talk) 06:06, 3 July 2025 (UTC)
Guiding an Improved Dementia Experience (GUIDE)
[edit]Guiding an Improved Dementia Experience (GUIDE) is a nationwide Medicare care model launched by the Centers for Medicare & Medicaid Services (CMS) on July 1, 2024.[1] The program is designed to deliver coordinated, team-based dementia care to community-dwelling Medicare beneficiaries and support their unpaid caregivers. GUIDE is part of CMS’s Center for Medicare and Medicaid Innovation and will run through 2032.
Background
[edit]The GUIDE model was developed in response to the increasing number of Americans living with Alzheimer's disease and other dementias. In 2023, more than 6.7 million people in the United States were affected by dementia.[2] The model is aligned with the goals of the National Alzheimer’s Project Act (NAPA), aiming to enhance care quality, reduce caregiver burden, avoid unnecessary hospitalizations, and delay institutionalization.
Structure
[edit]GUIDE includes two types of participants:
- Established Programs: Organizations that began delivering dementia care under GUIDE on July 1, 2024.
- New Programs: Organizations that entered a one-year pre-implementation phase starting in 2024 and will begin services on July 1, 2025.
Each participating provider must implement a Dementia Care Program (DCP) with an interdisciplinary team, including a care navigator, and offer comprehensive services through Medicare Part B.[3]
Services Provided
[edit]GUIDE services include:
- Dementia assessments and care planning
- 24/7 access to support and care navigation
- Medication and functional reviews
- Coordination with primary care and specialists
- Caregiver training, coaching, and support groups
- Annual reassessments
- Up to US$2,500 per year for caregiver respite services
Payment Model
[edit]CMS pays participating organizations a monthly Dementia Care Management Payment for each beneficiary. This replaces certain existing Medicare billing codes and includes supplemental funding for caregiver respite and program infrastructure. Program success is evaluated through quality metrics such as emergency department use, nursing home placement, and caregiver burden.
Eligibility
[edit]To qualify for GUIDE:
- The patient must be enrolled in Medicare Parts A and B
- Have a documented dementia or cognitive impairment diagnosis
- Live at home or in a community setting (e.g., assisted living)
- Not be enrolled in hospice or a PACE (Program of All-Inclusive Care for the Elderly)
Caregivers can reside in a different household and are also eligible for support and training through the model.
Example Participant: HōttoCare
[edit]HōttoCare is a dementia care provider based in the San Francisco Bay Area. It was selected by CMS as one of the organizations participating in the GUIDE model.[4] HōttoCare offers:
- In-home and telehealth dementia care
- Access to a care navigator and 24/7 support
- Regular cognitive assessments and care planning
- Caregiver coaching and support groups
- A $2,500 annual caregiver respite benefit funded by CMS
- Environmental safety assessments (beginning 2025)
HōttoCare serves communities in San Francisco, Alameda, Contra Costa, San Mateo, and Santa Clara counties.
See also
[edit]References
[edit]- ^ "GUIDE Model". Centers for Medicare & Medicaid Services. Retrieved 2025-07-03.
- ^ "Medicare to Improve Dementia Care for Individuals Living with Alzheimer's Disease". Alzheimer’s Association. Retrieved 2025-07-03.
- ^ "GUIDE Participant List". CMS. Retrieved 2025-07-03.
- ^ "HōttoCare: Dementia Care in the Bay Area". HōttoCare. Retrieved 2025-07-03.