We’ve talked a lot about comprehensive dementia care on the GeriPal podcast but while the evidence is clear that these programs work, the uptake has been limited largely because there hasn't been a strong financial case for it. Don’t get me wrong, the evidence points to cost savings, but as Chris Callahan and Kathleen Unroe pointed out in a JAGS editorial in 2020 “in comprehensive dementia care models, savings may accrue to Medicare, but the expenses accrue to a fluid and unstable network of local service providers, patients, and their families.”

The good news is that the financial case for comprehensive dementia care is changing thanks to a new Center for Medicare and Medicaid Innovation (CMMI) alternative payment model (APM) called Guiding an Improved Dementia Experience (GUIDE) Model. This model will give participating programs a per-member-per-month payment to offer care management, care coordination, and other services such as caregiver training, disease education, and respite.

On today's podcast we talk with Malaz Boustani of Indiana University, as well as Diane Ty, the senior director of the Milken Institute Center for the Future of Aging, about the GUIDE model. We’ll cover why the GUIDE model is important (hint - it all comes down to funding), how it was developed, what components will it include, and how it will be evaluated.

To read more about the GUIDE model, check out the following links:

Diane’s article in Health Affairs titled “A Promising Turning Point For Dementia Care: The GUIDE Model”
Another Health Affairs article titled “Applying An Evidence-Based Approach To Comprehensive Dementia Care Under The New GUIDE Model”
The CMS site if you are interested in learning more or applying to be a site (the application period will close on January 30, 2024)

Guiding an Improved Dementia Experience (GUIDE) Model: A Podcast with Malaz Boustani and Diane Ty

GeriPal - A Geriatrics and Palliative Medicine Podcast