By Keith A. Myers

Following an April 2023 presidential executive order directing federal agencies to work toward increasing access to high-quality care and caregiver support for both children and older adults in long-term care, the Centers for Medicare & Medicaid Services (CMS) on July 31, 2023, introduced the Guiding an Improved Dementia Experience (GUIDE) Model, a new initiative designed to improve the way care is delivered for people living with Alzheimer’s disease and other dementia, as well as enable them to stay in their homes and communities longer through a package of care coordination, caregiver education and support, and respite services.

This long-term Federal strategy focuses on three major challenges: improving care and support for those currently dealing with dementia; advancing research for effective medical treatments; and encouraging healthy people to make effective choices to reduce their risk of developing Alzheimer’s disease later in life. In addition to finding viable solutions to the day-to-day challenges of living with dementia and pursuing a medical breakthrough, progress is also being made in the often-daunting requirements associated with Medicare and Medicaid billing and payment.

The GUIDE Model, which will be tested nationwide by requesting organizations on a voluntary basis for eight years beginning July 1, 2024, will provide patients and their caregivers with a care navigator and 24/7 access support line for care coordination and clinical and non-clinical services such as meals and transportation through community-based organizations.

GUIDE is also designed to improve access to resources caregivers desperately need, such as respite services, which enable them to take temporary breaks from their caregiving responsibilities—an action proven to prevent or delay the need for their loved ones to enter facility-based care. The GUIDE Model has both bipartisan Congressional support and the enthusiastic endorsement of the Alzheimer’s Association, which noted that the program would save the federal government nearly $21 billion over 10 years by simply better coordinating how care is delivered.

A devastating Alzheimer’s diagnosis is often compounded by the financial impact on those who can least afford it. While some are fortunate enough to have a family member or loved one to provide the needed care, the obligations associated with being a caregiver are unpaid and without respite. In addition to providing 24/7 home care, being a caregiver involves coordinating appointments and fulfilling the often confusing and time-consuming billing requirements.

Once fully phased in, the GUIDE program would cover close to 1.8 million Medicare beneficiaries (about 20 percent of the population with dementia) by the end of the decade. For those living with dementia and suffering from multiple chronic conditions, it is also expected to decrease the fragmented care that can lead to otherwise-unnecessary hospitalizations and emergency department visits, as well as improve equitable access to healthcare. .

With researchers suggesting that the number of people living with Alzheimer’s will likely increase from an estimated 57 million in 2019 to 153 million by 2050, the GUIDE program is a step in the right direction.

Keith A. Myers is President & CEO, MorseLife Health Care System.