GUIDE Participants:
Want to speedup GUIDE implementation?
Hospital systems:
Want to join GUIDE as partner organization?
Patients / Caregivers:
Want to enroll in GUIDE?
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Must have traditional Medicare (not part of Medicare Advantage or PAC)
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Must have dementia diagnosis
Medicare Dementia GUIDE
Program
Medicare Dementia GUIDE Program:
In 2023, the Centers for Medicare & Medicaid Services (CMS) introduced the GUIDE model, short for "Guiding an Improved Dementia Experience." This optional program is designed to enhance the quality of life for dementia patients and their informal and family caregivers by emphasizing care coordination and support for caregivers.
Selected by CMS to implement GUIDE program, CareBrains and its coalition partners will be building Dementia Care Programs (DCPs) across the country, working to increase care coordination and improve access to services and supports, including respite care, for people living with dementia and their caregivers. Read the press release here.
We offer a range of services and tools to help meet GUIDE delivery requirements below.
COMPRESHENSIVE
ASSESSMENTS
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Telepsychiatry and telepsychology services (licensed in all states) to determine dementia stage required to enroll members
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Telephonic, telemedicine, and in-home visits to complete all required assessments for both patients and caregivers
CARE PLANS
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Develop individualized care plans based on assessment results to address all aspects of care needs for both patients and caregivers
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Automate task assignments and reminders to ensure care plan goals are met
24/7 ACCESS
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24/7 call center to support patient and caregiver needs (for select zip codes)
ONGOING MONITORING & SUPPORT
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Certified dementia care navigators to monitor progress and support patients and caregivers ongoing
REFERRAL & SUPPORT COORDINATION
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Care navigator identifies and connect patients and caregivers to community resources and services
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Care navigator helps complete application forms to qualify for community-based services
MEDICATION MANAGEMENT
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Clinicians review and reconcile medications
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Care navigators help ensure patient and caregiver understanding of how to adhere to medication regimen
CAREGIVER SUPPORT
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Free education programs for caregivers to help manage their loved ones
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Education topics include what to expect as the disease progresses, care options, communicating with family members, legal & financial planning
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Respite care up to $2500 / year
COORDINATION AND INTEGRATION
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Care navigator coordinates care and referrals to specialists, as well as care services
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Single point of contact for care needs and patient/caregiver portal & app for transparent communications
Additional Service to Help Implement GUIDE
CERTIFICATION TRAINING FOR STAFF & CAREGIVERS
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Certification training for your staff to become Certified Dementia Care Navigators to meet GUIDE requirements
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Caregiver training to continually engage family caregivers
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Incorporate training into required care plan tasks
CARE NAVIGATION SERVICES
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Care navigation services to help manage enrolled members, develop care plans, and provide ongoing monitoring & support
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Our team of Certified Dementia Care Navigators can supplement your team and ensure that your members receive the care they need.
REPORTING & BILLING
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Easily report on program metrics and bill for your GUIDE program services. We have been working with CMS to understand billing guidelines and developed easy-to-use tools to ensure billing success.
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Billing reports, invoices, and accounting amongst your partners will be generated automactically with transparent dashboard reporting.
CARE COORDINATION WEB PORTAL & APP
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Use an all-in-one dementia care coordination portal so all of your staff and partners can seamlessly coordinate dementia care while tracking billable encounters generated automatically.
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Track patient progress and configure your own dashboards for reporting and monitoring
Dementia Training & Certification Programs
Online, on-demand ACCME-accredited certification programs for doctors, nurses, social workers, and certification training for family caregivers.
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Self-paced videos
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Case study-based discussions
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Cross-discipline participants
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Immediately usable knowledge & practical skills
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Live or in-person available upon request
For Health Professionals
Improving Dementia Care and Patient Satisfaction
10-16 credit hours
Physicians: 10 AMA PRA Category 1 Credit(s)™️
Pharmacists: 10 ACPE Credits
Nurses: 10 contact hours
Psychologists: 10 CE Credits
Social Workers: 16 clinical continuing education credits
This course is for physicians, physician assistants, pharmacists, nurses, social workers, and other members of the healthcare team.
For Care Providers
Certified Dementia Care Navigator Program
Certificate of Completion
This course is for care professionals to qualify to provide care management and care coordination services. Elevate the standard of care and professional development while contributing to imporved patient outcomes.
Dementia Care Management & Family Caregiving Services
We help find the right care for patients with dementia.