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The Centers for Medicare & Medicaid Services (CMS) launched the Guiding an Improved Dementia Experience (GUIDE) model on July 1, designed to create more comprehensive, coordinated dementia care. Some home care providers have already been named as participants in the program, and many more plan to participate.

CMS hopes that the GUIDE model will improve the quality of life of people with dementia by allowing them to live longer in their own homes and communities and reducing the burden on their unpaid caregivers. It is a long-term commitment, designed to last eight years.

It will promote improved dementia care by defining and prescribing a comprehensive, standardized approach to care 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, CMS said.

The interdisciplinary nursing team delivers services by creating and maintaining a person-centered care plan that details the patient’s goals, strengths, and needs and includes comprehensive assessment findings and recommendations for care providers and community-based social services and support.

“Working with a direct participant benefits clients and caregiver families by providing a team-based approach to care,” Mari Baxter, COO of Senior Helpers, told Home Health Care News. “This ensures comprehensive care for the client and involves everyone involved in the process, ensuring consistency and quality. The GUIDE model also introduces families and clients to home care, making them safer at home and reducing hospital admissions.”

Maryland-based Senior Helpers is one of the largest home care franchises in the country, and while it is not a direct member of the GUIDE model, it plans to participate strategically in the future.

CMS said nearly 400 participating organizations, including Lifespark, InHome Connect, Providence Home Care and Andwell Health Partners, are building dementia care programs (DCPs).

Because GUIDE is a voluntary, nationwide model for Medicare Part B providers, it can benefit home care providers in many ways.

One option is to pay organizations to help them expand their DCPs and provide 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 facilities. Home care providers may be able to partner with other organizations to achieve participation if they do not meet all of the required guidelines.

“Participating in this model as a provider ultimately improves outcomes and reduces caregiver burden,” Baxter said. “This support can reduce caregiver burden and improve their ability to care for the client.”

The model is also expected to reduce Medicare and Medicaid spending by preventing or delaying long-term nursing home stays and reducing hospital, emergency room and post-acute care use.

“We want to do whatever it takes to keep people out of nursing homes,” Matt Kinne, COO of Lifespark, told Home Health Care News. “Nursing homes have their time and their place, but they are expensive. We know we can avoid a lot of low-value care by surrounding people with long-term, trusting, holistic relationships supported by geriatric expertise – that’s how we envisioned the GUIDE model.”

Headquartered in St. Louis Park, Minnesota, Lifespark offers a wide range of senior care services, including home health care, in-home nursing, primary care and emergency care in-home.

Kinne emphasized that the GUIDE model is valuable because it allows home care providers to not only focus on treating dementia and comorbidities in patients, but also provide support to families when needed.

“GUIDE allows us to provide a care coordinator and resources that would not otherwise be available to support families and individuals with dementia,” Kinne said. “It’s the funding, the resources and the ability to support people with real care coordination, with real expertise of a geriatric nurse practitioner who can work with families with complicated medical issues and dementia.”

The GUIDE model is also designed to help companies create services that meet people’s needs, providing additional support within the current fragmented system. Kinne said that given the lack of coordination among caregivers in the U.S. health care system, this is what will help people have a better quality of life.

However, Kinne stressed that when participating in this model, companies must focus on the long-term benefits for themselves and the families they serve.

“This is not a short-term opportunity,” he said. “When we evaluate things like GUIDE, we think about something that’s built to last a decade and is going to change people’s lives. This is a long-term commitment and I think it’s a really good move by CMS to invest here and give companies like us the opportunity to show and prove that there’s a better way to care for the seven million people in the U.S. who have dementia, many of whom have informal caregivers.”