CMS Selects OU Health to Participate in New Medicare Dementia Care Model

OU Health has been selected by the Centers for Medicare & Medicaid Services (CMS) as the only site in Oklahoma and one of almost 400 sites in the country to participate in a new Medicare program designed to support people living with dementia and their caregivers, working to increase care coordination and improve access to services and supports, including respite care.

Launched on July 1, 2024, the Guiding an Improved Dementia Experience (GUIDE) Model will test a new payment approach for key supportive services furnished to people living with dementia, including comprehensive, person-centered assessments and care plans; care coordination; 24/7 access to an interdisciplinary care team member or help line; and certain respite services to support caregivers.

“Our goal with GUIDE is to provide comprehensive, coordinated, high quality care for people living with Alzheimer’s disease and other dementias and to support their family and friend caregivers on their journey. We focus on helping people get the support they need to age in place,” said OU Health geriatrician Dr. Lee A. Jennings, M.D., MSHS, section chief of Geriatric Medicine at the University of Oklahoma College of Medicine. “We provide collaborative care which includes geriatrics, neurology, psychiatry, social work, pharmacy, and home-visits, and we work with the patient’s primary care provider to coordinate care. Additionally, we offer GUIDE participants free caregiver training through the Oklahoma Dementia Care Network to empower them to support their loved one with dementia.”

Dementia affects almost 7 million Americans, and it is projected that this rate will increase to 14 million cases by 2060. People living with dementia often have multiple chronic conditions and receive fragmented care, leading to high rates of hospitalization and emergency department visits.

OU Health offers comprehensive diagnostics for dementia patients. Medicare patients diagnosed with dementia can be referred to GUIDE so they can receive the benefit as well as monthly check-ins and 24/7 support. In addition, patients with dementia and their caregivers will have the assistance and support of a Care Navigator to help them access clinical and non-clinical services such as meals and transportation through community-based organizations.

“CMS is excited to partner with OU Health under the GUIDE Model,” said CMS Administrator Chiquita Brooks-LaSure. “GUIDE is a new approach to how Medicare will pay for the care of people living with dementia. The GUIDE participants are envisioning new ways to support not only people living with dementia, but also to reduce strain on the people who care for them, so that more Americans can remain in their homes and communities, rather than in institutions.”

The GUIDE Model also provides respite services for certain people, enabling caregivers to take temporary breaks from their caregiving responsibilities. Respite is being tested under the GUIDE Model to assess its effect on helping caregivers continue to care for their loved ones at home, preventing or delaying the need for facility care.

This model delivers on a promise in the Biden Administration’s Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers and aligns with the National Plan to Address Alzheimer’s Disease.

Learn more about memory care services at OU Health, an Age-Friendly Health System, or call (405) 271-3050.

For more information on CMS’ GUIDE Model, please visit: https://www.cms.gov/priorities/innovation/innovation-models/guide.