CMS GUIDE Model
The Centers for Medicare and Medicaid Services (CMS) has instituted "Guiding an Improved Dementia Experience" (GUIDE) program to service and support people living with dementia and their unpaid caregivers.
What it provides:
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The model includes caregiver training and support, respite care including in-home care, adult day care, 24/7 community suppor and telehealth services.
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In simple terms, it's a new way for Medicare to pay healthcare organizations to provide better, more coordinated care for people with dementia while supporting their family caregivers, with the goal of helping people stay at home longer rather than needing institutional care.
Main goals:​
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Better care coordination - Provides comprehensive, coordinated dementia care
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Quality of life - Aims to improve quality of life for people with dementia
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Home-based care - Helps individuals with dementia remain in their homes
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Caregiver support - Specifically supports unpaid family caregivers
To be eligible for Medicare’s GUIDE Program a beneficiary must meet the following criteria:
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Be a Traditional Medicare beneficiary
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Have a confirmed dementia diagnosis, such as Alzheimer’s, LBD, FTD, or vascular dementia
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Be enrolled in Medicare Parts A and B, with Medicare as their primary payer
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Not be enrolled in Medicare Advantage, including Special Needs Plans, or PACE programs
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Not have elected the Medicare hospice benefit
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Not be a long-term nursing home resident
