Essen Health Care Selected to Test Medicare Dementia Care Model

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Essen Health Care announced that it is participating in the Guiding an Improved Dementia Experience (GUIDE) Model, an initiative created by the Centers for Medicare and Medicaid Services (CMS).¹ The alternative payment model is meant to provide support and arrange care for patients living with dementia and their unpaid caregivers and allow more patients to receive care in the comfort of their own homes.

More than 55 million people worldwide suffer from dementia, with nearly 10 million new cases added each year.² The most common form of dementia is Alzheimer’s disease.

The GUIDE model, launched July 1^st of last year, is a voluntary nationwide model test scheduled to run until July 1^st, 2032. According to CMS, nearly 400 organizations across the nation are participating in the initiative.³ The model provides access to a support line, as well as training, education, and other support services. Individuals, known as care navigators, help dementia patients and their caregivers coordinate various services through programs in their communities.¹

"CMS is excited to partner with Essen Health Care under the GUIDE Model," CMS administrator, Chiquita Brooks-LaSure, said in the release. "GUIDE represents a transformative approach to how Medicare supports people living with dementia. The program not only envisions new care pathways for these individuals but also reduces the strain on caregivers, enabling more Americans to receive the care they need in familiar surroundings rather than institutional settings."

"We have always been committed to providing compassionate and comprehensive care to those who need it most. Our participation in the GUIDE Model is a natural extension of that commitment, as we strive to improve the quality of life for people living with dementia and their caregivers. By focusing on coordinated care and offering critical support services, we can help families navigate the challenges of dementia, allowing their loved ones to remain in the comfort of their homes and communities. We are honored to partner with CMS in this important endeavor and look forward to making a meaningful impact on the lives of those we serve," said Dr. Sumir Sahgal, founder and chief medical officer, Essen Health Care.

Women are disproportionately affected by dementia, both as patients and as caregivers. Female patients suffering from dementia spend more years living with the syndrome and have higher mortality rates. As caregivers, they’re the ones who are mostly likely to be taking care of others living with dementia, covering about 70% of care hours.³

"Essen Health Care's participation in the GUIDE Model will provide invaluable resources to those living with dementia and their caregivers," said Imelda Tavas, chief administrative officer, said in the release. "Through this model, we can offer education, support, and respite services that make a significant difference in the daily lives of caregivers and their loved ones."

This was in alignment with an executive order, signed in April 2023, by the Biden administration that aimed to improve job quality, increase and expand care options, and provide more support for the families and caregivers of people with dementia.⁴ This kind of standard would not only improve qualityof life, but would delay and potentially prevent the need for patients with dementia to be placed in nursing homes or similar facilities.

Sources

Essen Health Care Selected by CMS (Centers for Medicare & Medicaid Services) to Test Medicare Dementia Care Model. Essen Health Care. January 27, 2025. Accessed January 28, 2025. https://www.prnewswire.com/news-releases/essen-health-care-selected-by-cms-centers-for-medicare-amp-medicaid-services-to-test-medicare-dementia-care-model-875877947.html

Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers. April 22, 2024. Accessed January 28, 2025. https://www.cms.gov/newsroom/press-releases/biden-harris-administration-takes-historic-action-increase-access-quality-care-and-support-families#:~:text=The%20U.S.%20Department%20of%20Health,support%20America's%20families%20and%20workers.

Dementia. World Health Organization. March 15, 2023. Accessed January 28, 2025. https://www.who.int/news-room/fact-sheets/detail/dementia#:~:text=Dementia%20is%20a%20syndrome%20that,usual%20consequences%20of%20biological%20ageing

Executive Order 14095—Increasing Access to High-Quality Care and Supporting Caregivers. The American Presidency Project. April 18, 2023. Accessed January 28, 2025. https://www.presidency.ucsb.edu/documents/executive-order-14095-increasing-access-high-quality-care-and-supporting-caregivers