Charlotte, N.C.-based Advocate Health Care's academic core, Wake Forest School of Medicine, completed a multiyear clinical study on dementia care that played an instrumental role in the formation of the CMS GUIDE model.
In early July, CMS launched a program designed to improve the lives of people with dementia and reduce the strain on their unpaid caregivers. The program will test alternative Medicare payments for delivering key services and include care navigators and nonclinical services. The GUIDE program is being launched at 400 organizations across the country.
It was shaped in part by experts who helped provide evidence for the process. This includes a study done by Advocate Health that was submitted to CMS during its information-gathering period.
"With 11% of the 65-plus population diagnosed with Alzheimer's, we need new payment models and policies to provide adequate support. This is a great example of a learning health system in action," Jennifer Houlihan, vice president of policy and research application and enterprise population health at Advocate Health, told Becker's. "We're translating pragmatic research into an innovative care management and payment model, with CMS recognizing its value."
Between 2019 and 2023, Winston-Salem, N.C.-based Wake Forest School of Medicine researchers compared two evidence-based dementia care models. The study, called Dementia Care Study or D-CARE, compared a community-based model led by social workers from local nonprofits to a system-based model led by advanced practice providers. Four thousand dementia patients and their caregivers were enrolled in the study, making it the largest dementia care study ever done, Mia Yang, MD, associate professor of gerontology and geriatric medicine at Wake Forest School of Medicine, told Becker's.
The D-CARE study included many components that are now required in CMS' new GUIDE program, including 24-hour access to on-call lines, the interdisciplinary team and ongoing proactive management on patients based on disease severity and caregiver burden.
"All the infrastructure we're building now, like the electronic medical record and data workflows, can be scaled to the other sites," Dr. Yang said. "This means they won't have to start from scratch when they implement this year, aiming to open enrollment by July 2025."
The study is under peer review.