The U.S. Centers for Medicare & Medicaid Services (CMS) has outlined the range of services that will be available to patients aligned with the agency’s Guiding an Improved Dementia Experience (GUIDE) payment model.
The payment model is designed to improve quality of life for dementia patients and their caregivers by addressing care coordination, behavioral health and functional needs. While the model does not use the term “palliative care,” it does incorporate principles and practices traditionally associated with those services, such as interdisciplinary care and caregiver support, among others.
“[Dementia Care Programs (DCPs)] represent a wide range of health care providers, including large academic medical centers, small group practices, community-based organizations, health systems, hospice agencies, telehealth organizations and other practices,” the agency indicated in a statement. “The GUIDE Model aims to improve the quality of life for people living with dementia, reduce strain on unpaid caregivers and help people remain in their homes and communities through a package of care coordination and management, caregiver education and support and respite services.”
When the program was announced last year, CMS indicated to Hospice News that opportunities exist for hospice and palliative care providers within the model. Many of those providers agree.
More than 40 hospice- and palliative care-specific organizations are participating, including Andwell Health Partners, Avow Care Services, Gilchrist Hospice Care, HopeWest and the Icahn School of Medicine at Mount Sinai. Additional palliative care provider participants include Chapters Health Palliative Care, Hospice of the Chesapeake and Sangre de Cristo Hospice & Palliative Care, among others.
Also participating in the model are primary care operators that also offer palliative care. All told, nearly 400 health care organizations are developing Dementia Care Programs (DCPs) to potentially serve hundreds of thousands of Medicare beneficiaries nationwide, the CMS stated in a fact sheet.
Health care providers can expect an influx of patients with dementia-related conditions in the coming years
Nearly 6.7 million seniors in the United States have been diagnosed with Alzheimer’s or other dementias, according to a 2023 report from the Alzheimer’s Association. By 2050, this is expected to nearly double to 12.7 million people.
