Posted Wednesday, August 2, 2023
The Biden-Harris Administration is taking further action on its commitment to promote care and support for people with Medicare living with dementia and their unpaid caregivers. On July 31, 2023, the U.S. Department of Health and Human Services (HHS), through CMS announced its Guiding an Improved Dementia Experience (GUIDE) Model, which aims 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 GUIDE Model will be tested by the Center for Medicare and Medicaid Innovation and is a key deliverable from President Biden’s April 2023 Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers, as well as key goals of the National Plan to Address Alzheimer’s Disease (National Plan).
“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.”
“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.
Patients will be stratified into one of five tiers, based on a combination of their disease stage and caregiver status. Care intensity and payment increase by tier, according to CMS.
Reimbursement through the model includes a per-member, per-month payment, as well as an infrastructure payment for some safety net providers. Participating operators may also receive payment for respite care.
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