What Is the CMS GUIDE Model: A Paradigm Shift in Dementia Care

Dementia is an escalating challenge in America, affecting more than 6.7 million people. As the number of people living with dementia continues to rise, so does the complexity of ensuring their care and well-being. The GUIDE Model aims to address the growing need for support.

 On July 31, 2023, the Centers for Medicare & Medicaid Services (CMS) unveiled the Guiding an Improved Dementia Experience (GUIDE) Model to help those with dementia and their caregivers, marking a significant leap in the commitment of the U.S. government to elevate care standards and support for individuals with dementia. The GUIDE Model is scheduled to start in July 2024.

GUIDE Model Overview

The GUIDE Model is a transformative, eight-year program that aims to ensure comprehensive care for people with dementia, keep them living at home for longer, and provide caregivers with access to resources and support. The model encourages Medicare Part B-affiliated providers to participate through a variety of new payment structures. 

At the heart of GUIDE  is a fundamental belief in the power of collaborative, interdisciplinary care. Every entity wishing to participate is mandated to assemble a cohesive care team that aligns with GUIDE’s stringent care benchmarks. This collaborative unit is built around:

The Care Navigator: The Care Navigator is a dementia expert who can administer assessments and oversee care planning. They can guide people living with dementia and their caregivers to clinical resources like doctors, and non-clinical resources such as meal delivery and transportation services. 

The Dementia-Specialized Clinician: This medical professional will either have experience in overseeing adults with cognitive challenges, or experience with patients aged 65+. Specialities may include neurology, geriatric psychiatry, or behavioral neurology.

Focus on Quality of Care and Caregiver Support

The GUIDE Model’s approach to dementia care is revolutionary. A central pillar is the 24/7 support line, ensuring that assistance is always just a call away. Additionally, unpaid caregivers will receive training, support, and respite care in an effort to reduce their burden and improve their overall well-being. Emphasizing health equity, the GUIDE Model seeks to minimize disparities, ensuring every person, regardless of background, receives optimal care. 

The below infographic, created by CMS, illustrates how the GUIDE Model can improve care for individuals with dementia:

Illustration showing two paths of a dementia patient under the GUIDE model vs without it

cms.gov

GUIDE Model and Trualta

Incorporating caregiver education platforms like Trualta within the GUIDE Model could bridge the existing gap in dementia care. By providing tailored training and resources, platforms such as Trualta emphasize caregiver preparedness and confidence, which can improve outcomes.

Caregiver Support Is the Future

GUIDE provides hope to people living with dementia and their unpaid caregivers. As CMS Deputy Administrator and Innovation Center Director Liz Fowler pointed out, “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.” Ultimately, people with dementia will be able to live safely at home for longer, and will be able to reduce repeat hospitalizations and emergency room visits.

For health plan and healthcare provider executives, integrating caregiver support strategies is no longer a choice but a necessity. The future of healthcare mandates an approach where holistic care is at the forefront, and the GUIDE Model is the embodiment of this paradigm shift. 

Call to Action

Discover the transformative potential of the GUIDE Model. Delve deeper on the official CMS website. If you’re a healthcare strategist, now is the time to integrate or support this groundbreaking model. Reach out to CMS for more information or to express your intent to join this movement.

2023-08-17T09:52:00-04:00