The GUIDE model is a per member, per month model to help support people with dementia and their caregivers. CMS accepted GUIDE participants (i.e. organizations that will be receiving money from CMS to administer the model) for two cohorts. The first cohort begins on July 1, 2024; the second will launch on July 1, 2025.

GUIDE participants for 2025 may be reaching out to your clients and residents to promote GUIDE services which includes caregiver support, care coordination, and more. These may be services that you already provide and/or services that you try to manage on your campuses.

Members are encouraged to consider creating a communication to all clients and residents to let them know that 1) you are aware of GUIDE; 2) endorse what CMS is hoping to accomplish with this unique and important program; 3) while many of the details regarding this program are still unfolding, you and your team are working to stay abreast of the program, its benefits, and how you can be as helpful as possible in ensuring that residents and clients are aware of the full cadre of benefits available; and 4) that you have a contact on your team to whom they can address questions.

Members can use the CMS  fact sheet on GUIDE and the LeadingAge GUIDE webinar with CMMI staff (free for members) which discusses the model from the perspective of LeadingAge members.

While the model participant opportunities are now closed, it is not too late to evaluate whether your organization is interested in partnering with one of the CMS-approved model participants so it may also be worth reaching out to GUIDE participants to assess these possibilities.

Once the model participants are public, LeadingAge will work to organize a meeting for GUIDE participants that are LeadingAge members.

LeadingAge has learned that CMS Innovation Center (CMMI) notified applicants for the GUIDE model whether or not they were accepted on April 3. If you were accepted, please let Mollie Gurian know at mgurian@leadingage.org.

On Monday, November 27 from 2–2:30 p.m. ET, LeadingAge Consultant ATI Advisory will host a webinar to help providers learn more about the CMMI Guide Model. Experts Tyler Cromer and Tina Pickett will talk about opportunities for organizations and answer your questions. Register here to join the webinar—and learn more about how LeadingAge Consulting offers members access to deeper levels of direct support through strategic consulting.

CMMI released the Guiding an Improved Dementia Experience (GUIDE) model request for applications. The application portal for the Model opened on November 15 and will close on January 30, 2024. CMMI will announce the selected participants and their tracks in Spring 2024. The model will launch on July 1, 2024, and run for eight years.

LeadingAge will be reading the RFA and providing more analysis in the coming days.

On August 30, LeadingAge hosted a webinar in which CMS Innovation Center (CMMI) staff, along with two LeadingAge staff, discussed the Guiding an Improved Dementia Experience (GUIDE) model and how aging service providers might lead or participate in the model. If you missed it or want to listen again, the recording is now available on the LeadingAge Learning Hub and can be found here (click on the Add to Cart button to access the recording).  Those who may be interested in being part of the model are reminded that the Letter of Intent to participate is due on September 15.

The Centers for Medicare & Medicaid Services (CMS) held a Guiding An Improved Dementia Experience (GUIDE) model overview on August 10, and members will have access to the recording and slides soon. LeadingAge members will also have access to a members-only webinar on the GUIDE model with the CMMI team on August 30 at 11 a.m. ET. Registration details are coming soon.

CMMI supports developing and testing innovative health care payment and service delivery models aimed to achieve better care, better community health, and lower costs for the health care system. For a detailed look into the GUIDE model and how it can be a funding opportunity for aging services providers to offer more coordinated care, see the full LeadingAge article.

On July 31, the Center for Medicare and Medicaid Innovation (CMMI) announced the Guiding an Improved Dementia Experience (GUIDE) model. GUIDE is an eight-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 durable medical equipment 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 Fee for Service Medicare, 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, and 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 2 p.m. ET. Registration can be found here.

A nonbinding letter of interest is due on September 15th, 2023.

A more detailed article from LeadingAge on the model will be forthcoming.  Read LeadingAge’s statement on the GUIDE Model here; more information on the model from CMMI can be found here.

LeadingAge released a statement from president and CEO Katie Smith Sloan on the announcement from the Centers of Medicare and Medicaid Services (CMS) of its Guiding an Improved Dementia Experience (GUIDE) Model:

“Nonprofit, mission-driven aging service providers know that caring for an older adult with dementia is complex—and that family and friends are a critical part of the care team. Many of our provider members already dedicate time and resources to educating unpaid caregivers, and need alternative payment models like the one announced today to support those efforts and help keep people in the setting of their choice. We appreciate the Biden Administration’s attention on how to ensure that unpaid caregivers as well as those they care for are part of how older Americans receive the quality care they need wherever they call home.”