Northwell Selected by CMS to test Medicare dementia care program

Northwell Health has been selected by the Centers for Medicare & Medicaid Services (CMS) to participate in a new Medicare alternative payment model designed to support people living with dementia and their caregivers. The federal program launched July 1 and is slated to run eight years.

Under CMS’ new Guiding an Improved Dementia Experience (GUIDE) Model, Northwell will be one of almost 400 participants, but also one of 96 already established programs, building Dementia Care Programs (DCPs) nationwide working to increase care coordination and improve access to services and supports, including respite care, for people living with dementia and their caregivers.

Northwell has had much success among its dementia patients and their caregivers.

“I really believe your support helped me immensely in understanding and handling my mother’s dementia diagnosis,” a caregiver said. “It was not easy at times, but always I felt I could reach out to you anytime and you never hesitated to help me when I needed it.”

“Northwell and its team of clinicians with expertise in memory evaluation and management are excited to be selected as an established GUIDE Model site,” said Maria Torroella Carney, MD, division chief of Geriatrics and Palliative Medicine at Northwell. “It’s our hope to provide some relief and support to individuals and their loved ones throughout their journey with dementia and as they face other health issues.”

The 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. People 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.

Northwell Health’s participation in the GUIDE Model will help people in the region living with dementia and their caregivers have access to education and support, such as training programs on best practices for caring for a loved one living with the disease. The GUIDE Model also provides respite services, enabling caregivers to take temporary breaks from their caretaker responsibilities. Respite is being tested under the GUIDE Model to assess its effect on helping caregivers continue to look after loved ones at home while preventing or delaying the need for facility care.

“CMS is excited to partner with Northwell Health under the GUIDE Model,” said Chiquita Brooks-LaSure, CMS’ administrator. “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 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.

For further information on CMS’ GUIDE Model, visit: https://www.cms.gov/priorities/innovation/innovation-models/guide or call Northwell geriatrics and Palliative Medicine in New Hyde Park at (516) 708-2520.

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