The application submission period for the Guiding an Improved Dementia Experience (GUIDE) Model ended on January 30, 2024.
The Guiding an Improved Dementia Experience (GUIDE) Model is a new voluntary, nationwide model for Medicare Part B providers from the Centers for Medicare & Medicaid Services (CMS) that 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.
Please visit the Centers for Medicare & Medicaid Services (CMS)’s website for additional information on the GUIDE Model:
GUIDE participants will be Medicare Part B enrolled providers/suppliers, excluding durable medical equipment (DME) and laboratory suppliers, who are eligible to bill for Medicare Physician Fee Schedule service and agree to meet the care delivery requirements of the model. If the GUIDE participant can’t meet the GUIDE care delivery requirements alone, they can contract with other organizations, including both Medicare-enrolled and non-Medicare enrolled entities, to meet the care delivery requirements.
The Model’s core payment methodology is a per beneficiary per month care management payment, called the Dementia Care Management Payment (DCMP), that is adjusted for health equity and performance on a set of quality metrics, plus a separate payment for respite services. The dementia care management payment (DCMP) under GUIDE provides:
- Care management and coordination
- Caregiver education
- Support services to beneficiaries and caregivers. To further support caregivers, qualifying beneficiaries can receive funds for respite services.
The DCMP per beneficiary per month payment rates are as follows:
Under the GUIDE model, new G-codes are available for DCMP and respite services. Visit GUIDE Models Payment Methodology for more information.
The application submission period for the Guiding an Improved Dementia Experience (GUIDE) Model ended on January 30, 2024. CMS released the Request for Applications (RFA) on November 15, 2023 and interested applicants were instructed to submit their application via this web portal. The launch of the GUIDE model is on July 1, 2024, and will run for eight years. Currently, the GUIDE Model has only one application cycle to allow time for implementation, evaluation, and improvement of dementia care outcomes.
The model will offer two tracks. All applicants will apply at the same time, and CMS will assign them to either the established program track or the new program track based on the information provided in their application. Track assignment will depend on whether a program is providing comprehensive dementia care at the time of model announcement.
- Established Programs
- Performance period begins July 1, 2024
- New Programs
- Pre-Implementation period begins July 1, 2024 for program development:
- Hiring and training staff
- Establishing program workflows and processes
- Developing referral networks
- Building relationship with community-based providers and respite providers
- Performance period begins July 1, 2025
- Pre-Implementation period begins July 1, 2024 for program development:
How can I get support and assistance on the application?
Support and assistance are available through the CMS Website, which provides technical assistance and pre-implementation year support.
To reach a California Alzheimer’s Association Health Systems Director for assistance with the application, please reach out to CAHSD@alz.org
Where can I look for potential partners?
GUIDE participants may choose to partner with other organizations to meet the care delivery requirements of the model, including non-Medicare enrolled entities. This includes the option to enter into an agreement with a local Area Agency on Aging (AAA) or Tribal Aging program to help with coordinating community-based services and supports (per page 71 of the RFA). The following websites may help applicants identify potential partners in their area for services such as caregiver education and support; referral and coordination of services; and/or respite. Note that some of the organizations below may be able to provide more than one type of service.
Referral and Coordination of Services and Supports
Caregiver Education and Support
- Caregiver Resource Centers Map
- Alzheimer’s Association
- Alzheimer’s Los Angeles
- Alzheimer’s Orange County
- Alzheimer’s San Diego
Respite/Adult Day Services
Webinars
CMS’s GUIDE Model Overview Webinar (August 10, 2023)
Recording with slides, slides, and transcript
HRSA’s 
GUIDE Model Overview Webinar (September 12, 2023)
Recording with slides and transcript
Manatt’s “Guiding an Improved Dementia Experience: A Deep Dive into CMS’s New GUIDE Model” (September 13, 2023)
Information, recording, and slides
Health Affairs’ “Policy Spotlight: One-on-One with Liz Fowler, Director of the Center for Medicare and Medicaid Innovation (CMMI) at CMS/HHS” (September 14, 2023) Recording
ATI Advisory’s “Discovering Pathways of Support: What CMS’s new GUIDE Model means for dementia patients, caregivers, and providers” (September 27, 2023) Recording
ATI Advisory’s “Navigating the Decision to Apply to CMS’s GUIDE Model for Dementia Care Management” (November 27, 2023)
Information with slides, and recording
Education Development Center’s National Dementia Care Collaborative (NDCC) Autumn Summit, The CMS GUIDE Model: Choices for Implementing Evidence-Based Dementia Care (November 28, 2023) Recording and presentation slides
CMS’s Request for Applications (RFA) Webinar for Guiding an Improved Dementia Experience (GUIDE) Model (November 30, 2023)
Recording, slides, and transcript
DHCS & Dementia Care Aware’s “Applying for the GUIDE model in California with Dave Reuben, MD” (December 8, 2023)
Recording and presentation slides
CMS’s GUIDE Model Application Process Office Hour (January 11, 2024)
Recording with slides (Part 1 and Part 2), slides, and transcript
Articles
Guiding the GUIDE Model Toward Stronger Caregiver Supports
With general questions, please email the CMS GUIDE Model team at GUIDEModelTeam@cms.hhs.gov
Prospective GUIDE applicants who are in California and have additional questions or are looking for specific resources, please fill out the form below. Your questions and comments will be used to inform the development of further resources and services.
