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The Centers for Medicare & Medicaid Services (CMS) launched the Guiding an Improved Dementia Experience (GUIDE) Model on July 1, which aims to create more comprehensive, coordinated dementia care. Some home-based care providers have been named participants in the program, and many more plan to get involved.
CMS hopes the GUIDE Model will improve the quality of life for people with dementia, enabling them to live longer in their homes and communities and reducing strain on their unpaid caregivers. It is a long-term commitment, set to run for eight years.
It will promote improved dementia care by defining and requiring a comprehensive, standardized care delivery approach that includes a standardized set of services for patients and their caregivers, an interdisciplinary care team and a training requirement for care navigators who are part of the care team, according to CMS.
The interdisciplinary care team will deliver services by creating and maintaining a person-centered care plan that details the patient’s goals, strengths and needs, as well as comprehensive assessment results and recommendations for service providers and community-based social services and supports.
“Working with a direct participant benefits the clients and family caregiver by providing a team-based approach to care,” Senior Helpers COO Mari Baxter told Home Health Care News. “This ensures comprehensive care for the client and involves all parties in the process, maintaining consistency and quality. The GUIDE Model also introduces families and clients to home care, keeping them safer at home and reducing hospital admissions.”
The Maryland-based Senior Helpers is one of the largest home care franchises in the country. And while it is not a direct participant in the GUIDE Model, it plans to be strategically involved with it moving forward.
CMS said nearly 400 participating organizations, including Lifespark, InHome Connect, Providence Home Care, and Andwell Health Partners, are building Dementia Care Programs (DCPs).
Given that GUIDE is a voluntary, nationwide model for Medicare Part B providers, it can benefit home care providers in several ways.
One such way is that it pays organizations to help them expand their DCPs and provides care coordination and service management. Another benefit is that GUIDE participants can contract with other providers, suppliers and organizations to meet care delivery requirements. These partner organizations can include both Medicare-enrolled and non-Medicare-enrolled entities. Home care providers may be able to partner with other organizations to gain participation if they don’t meet all the necessary guidelines.
“Participating in the model as a provider ultimately improves outcomes and reduces the burden on caregivers,” Baxter said. “This support can reduce caregiver strain and improve their ability to care for the client.”
The model is also expected to reduce Medicare and Medicaid expenditures by preventing or delaying long-term nursing home stays and reducing hospital, emergency department and post-acute care usage.
“We want to do whatever it takes to keep people out of the nursing home,” Lifespark COO Matt Kinne told Home Health Care News. “There’s a time and a place for nursing homes, but they are expensive. We know that by surrounding people with longitudinal, trusting, holistic relationships supported by geriatric expertise, which is how we’ve contemplated the GUIDE Model, we can eliminate a lot of low-value care.”
Lifespark, headquartered in St. Louis Park, Minnesota, offers a wide range of senior care services, including home health care, home care, home-based primary care and home-based urgent care.
Kinne emphasized that the GUIDE Model is valuable because it enables home-based care companies to focus not only on addressing dementia and comorbidities in patients, but also by providing support for families when they need it.
“GUIDE allows us to provide a care coordinator and resources that otherwise wouldn’t exist to support families and individuals living with dementia,” Kinne said. “It is funding, resources and the ability to support people with real care coordination, with real geriatric nurse practitioner expertise that can work alongside families with complicated medical issues and dementia.”
The GUIDE Model also aims to assist businesses in creating services that align with people’s needs, providing additional support within the currently fragmented system. Kinne said that given the U.S. health care system’s lack of coordination among caregivers, that is what will help individuals move toward a better quality of life.
However, Kinne emphasized that companies must prioritize long-term benefits for themselves and the families they care for when participating in this model.
“This is not an opportunity for the short term,” he said. “When we evaluate things like GUIDE, we think about something built to last for a decade that will change people’s lives. This is a long-term commitment and, I think, a really good move by CMS to invest in this and give companies like us the opportunity to demonstrate and show that there is a better way to care for seven million people in the U.S. living with dementia, many of which have informal caregivers.”
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