ARTICLE | WEBINAR RECAP
ARTICLE | WEBINAR RECAP
Key Takeaways:
As the CMS GUIDE program’s deadlines get closer, there is still a lot for providers to understand about the model and what they’ll need in order to apply and participate.
In partnership with Pearl Health, we brought together an expert panel to discuss the intricacies and value of the program. Bahamia Ulysse, ianacare’s Director of Caregiver Navigator Program moderated and facilitated an educational conversation with Dr. Cam Berg of Pearl Health and Dhruv Vasishtha, an ianacare advisor.
Below is an overview of key learnings and takeaways from the event, but our speakers shared even more deep knowledge and expertise, so be sure to check out the full webinar recording here.
The Centers for Medicare & Medicaid Services (CMS) has initiated the GUIDE model for Guiding an Improved Dementia Experience.
It aims to improve dementia patients’ quality of life and their family caregivers by providing tailored support and interventions that impact health and medical outcomes.
"This is not a shared savings program…CMS is not looking to see how GUIDE itself is going to demonstrate shared savings with an attributed population.
Rather, its intent is to, first and foremost, incentivize the assessment of cognitive impairments and finance caregiver supports."
Interdisciplinary team creates person-centered care plan
Continuous monitoring and care
Training, education and support groups for caregivers
Expert Care Navigators facilitate access to clinical and non-clinical resources
Access to a 24/7 support hotline
Caregivers receive respite services up to $2,500/year
"Caregiver respite is the number one request we get from our caregivers time and time again."
Dementia patients navigate our health system differently. This disease presents particular challenges that lead to both wasteful and non-existent care, leaving patients and their families with few options for treatment and support. Proper care for these patients is a problem we all face, and it affects everyone.
Historically and currently, all efforts to address the dementia population have been fragmented and ineffective. With few clinical and therapeutic options, CMS is now turning focus to those that care for these patients and often bear the heaviest burden of care. Rolling these resources into supplemental models with GUIDE will be a huge step.
CMS, for the first time, is offering large capital to providers to address caregiver support for the duration of the program– 8 years. The model is accessible and achievable for providers to participate in.
"The caregiver is experiencing this illness at the same magnitude as the patient. And this model does actually address both sides of that equation...GUIDE will make the journey more aligned, and reduce the total cost of care."
Caregivers are crucial in managing dementia. They are deeply involved in care planning and patient monitoring.
Supporting caregivers not only aids in achieving better health outcomes for dementia patients but also helps in reducing costs related to dementia care.
Comprehensive support for caregivers range from providing proper access to necessary resources like training, support groups, and navigation to medication management. Provision of 24/7 support help-line specifically for caregivers is one of the standout features of the GUIDE model.
In order to meet the support requirements needed to apply to GUIDE, providers will likely need to enter into partnerships with external vendors who have existing essential caregiver support infrastructures. These existing solutions, technology platforms and specialized services can significantly advance providers’ efforts in supporting dementia caregivers.
The program will run for eight years, presenting an exciting opportunity for CMS to provide targeted support to dementia caregivers and patients, while also hoping to reduce costs. This new approach is likely to evolve into other high-risk populations, showing a promising future for value-based care in the US.
Throughout the webinar, the audience sent in lots of great, thoughtful questions. Our panelists didn’t have a chance to answer each question live, so we wanted to feature some of those questions below, with answers from our experts:
Dr. Cameron Berg: “The concept of having prospective payments that are supplemental and oriented to more than just the patient with the idea of reducing total cost of care on a multi-year level is thrilling. That’s what we should be doing in value based care. We’re trying it in dementia and that’s very exciting. I think CMS will extrapolate this to other high risk populations based on the success of the program.”
Dhruv Vasishtha: “I think is really exciting… the upskilling of family caregivers. At the end of the day, it’s just such a no brainer, but we really have only recently started to do this at scale. There’s this recognition that if you’re really able to train caregivers, not just on the ADLs, but in the tough advanced care planning conversations, or, you know, in palliative care, those types of elements allow people to age with dignity, honor their wishes, and actually have, as literature shows, better outcomes. So I think that that is really interesting and exciting to me… there’s just so much low hanging potential there.”
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Dhruv Vasishtha: “So, when I think about this, obviously the best case scenario is that this is something like the first gen ACO model, which CMS keeps on reinvesting and reinforcing in different versions. The way that I view this is that CMS is going to be doing something with caregivers as Cam mentioned, this is a new category and they’ve put out this long, eight year program.
I’m really excited that our organizations are saying we’re putting our foot in the door and we’re really going to start doing this because I think that even if it’s not GUIDE, it’s going to have different reincarnations or incarnations either by CMS or as other benefits modeling the program at other value based providers.“
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