CMS GUIDE Program

Looking for the LECOM Center for Memory Impairment and Neurocognitive Disorders (MIND)?

Guiding an Improved Dementia Experience (GUIDE) Model

New Medicare Alternative Payment Model

LECOM 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. Under CMS’ Guiding an Improved Dementia Experience (GUIDE) Model, LECOM Health is one of almost 400 participants 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.

Eligibility for voluntary alignment according to the following criteria:  

• Has mild, moderate, or severe dementia, as confirmed by a GUIDE Practitioner’s attestation on a Patient Assessment and Alignment form
• Is enrolled in both Medicare Parts A and B
• Has Medicare as their primary payer
• Is not enrolled in Medicare Advantage or another Medicare health plan, including Special Nees Plans (SNPs) and the Program of All-Inclusive Care for the Elderly (PACE)
• Is not enrolled in Medicare hospice benefit
• Is not a Long-Term Nursing Home Resident; and
• Is not aligned to another GUIDE Model Participant
• Must live within the zip-code-based service area

A GUIDE Beneficiary will no longer qualify for GUIDE-Model services following any of the following occurrences: 

• The GUIDE Beneficiary’s death
• The GUIDE Beneficiary is a Long-Term Nursing Home Resident
• The GUIDE Beneficiary enrolls in the Medicare Hospice Benefit
• The GUIDE Beneficiary enrolls in PACE
• The GUIDE Beneficiary enrolls in a Medicare Advantage Plan
• The GUIDE Practitioner attests in writing to CMS that the GUIDE Beneficiary no longer has mild, moderate, or severe dementia
• The GUIDE Beneficiary, or their legal representative, makes a request to LECOM Center for Memory Impairment and Neurocognitive Disorders (MIND) to no longer receive services under the GUIDE Model
• The GUIDE Beneficiary moves out of the Participant’s Zip-Code Based Service Area
• The GUIDE Beneficiary does not receive GUIDE services for a period of 8 months

Contact us to learn more about the GUIDE program: 814-500-9111