On July 31st, the Center for Medicare and Medicaid Innovation (CMMI) announced the Guiding an Improved Dementia Experience (GUIDE) model.
- GUIDE is an 8-year voluntary model that will be available to be offered by eligible providers in all 50 states, the U.S. territories, and DC. The model is designed to attract a range of Medicare Part B providers with expertise and capabilities to provide ongoing longitudinal care and support for people living with dementia and those who care for them. This model is focused on dementia care in the home and community.
- Eligible providers must be Medicare Part B enrolled providers/suppliers excluding DME and laboratory providers who are eligible to bill the Physician Fee Schedule services and agree to meet the care delivery requirements of the model. If a potential participant cannot meet the care delivery requirements alone, they can contract to meet them.
- Eligible beneficiaries must be enrolled in Medicare FFS, not residing in a nursing home, and not be enrolled in PACE or hospice. Hospice and PACE organizations can participate if they utilize a separate Part B TIN.
- Payment will be a monthly per beneficiary per month payment for providing care management and coordination, caregiver education and support services. Services are to be provided to both beneficiaries and their unpaid caregivers. There is a separate respite care payment and for some providers, an infrastructure payment to support program development activities.
- There are two program tracks – an established program and a new program. Established programs will begin the model on July 1, 2024. New programs will start on July 1, 2025; the 2024-2025 year will be a pre-implementation year.
A webinar on the new GUIDE model is being offered on August 10, 2023 at 1:00 PM CST. Click HERE to register.
A nonbinding letter of interest is due on September 15, 2023.
A more detailed article from LeadingAge on the model will be forthcoming. Review more information on the model from CMMI.
