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GUIDE Individuals have the option, and are not needed, to make readily available break through an adult day center or a 24-hour center. Additional GUIDE Break Solutions requirements and information surrounding the payment for such services are defined in the Participation Contract.

The facilities payment is meant for service providers who desire to develop new dementia care programs and need resources to begin. GUIDE Participants certified as a safeguard supplier based upon the percentage of their client population that is dually eligible for Medicare and Medicaid or get the Part D low-income aid.

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To qualify as a GUIDE safeguard supplier, a new program candidate need to have had a Medicare FFS beneficiary population consisted of a minimum of 36% beneficiaries getting the Part D low-income aid or 33.7% recipients who are dually qualified for Medicare and Medicaid. Accepting the infrastructure payment was optional. Neither the Dementia Care Management Payment (DCMP) nor GUIDE break services will undergo recipient cost-sharing.

When an aligned recipient is re-assessed and assigned to a brand-new tier, the GUIDE Participant will be qualified to bill the G-code for the recognized client payment rate connected with that tier the following month. GUIDE Individuals that withdraw or are terminated before the start of the 2nd performance year will be needed to pay back the entire value of their facilities payment to CMS.

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After the second performance year, GUIDE Participants that withdraw or are ended from the GUIDE Design are not required to pay back the facilities payment. The main design payment under the GUIDE Design is a per-beneficiary, per-month care management payment called the Dementia Care Management Payment (DCMP). The DCMP will replace fee-for-service payment for some existing Medicare Physician Charge Schedule (PFS) services, consisting of chronic care management and principal care management, transitional care management, advance care planning, and technology-based check-ins.

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The GUIDE Model is not a total-cost-of-care design, so GUIDE Participants will continue to expense under traditional Medicare fee-for-service for all services that are not consisted of under the DCMP. CMS might add or get rid of codes over time to reflect changes in PFS billing codes.

The care team might include the beneficiary's medical care company, and if not, the care team is required to identify and share info with the recipient's medical care provider and specialists and outline the care coordination services required to handle the recipient's dementia and co-occurring conditions. CMS will offer GUIDE Participants information related to the efficiency determines that CMS utilizes to figure out the GUIDE Individual's performance-based adjustment to the DCMP.GUIDE Participants in the established program track must be prepared to start providing services under the GUIDE Design on July 1, 2024, and expense for those services during the Design Performance Period.

Yes, GUIDE recipient and provider overlap with the Shared Cost savings Program is allowed. The GUIDE Model is created to be suitable with other CMS designs and programs that intend to improve care and lower costs. CMS believes targeted support for individuals with dementia and their caregivers will help enhance population-based care outcomes overall.

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As an example, if an ACO is participating in both the GUIDE Model and the Shared Cost Savings Program during Efficiency Year 2024 and then renews and begins a brand-new agreement duration as of January 1, 2025, that ACO would have their Shared Savings Program standard based on 2022, 2023 and 2024, and would have DCMPs counted in Criteria Year 3. GUIDE Break Service claims will not be counted towards ACO expenses, shared savings, nor benchmarking beginning in 2024 for the duration of the GUIDE Design.

GUIDE Participants may participate in multiple CMS Innovation Center designs or Medicare value-based care initiatives to accelerate development in care shipment, lower the cost of care, and enhance population health. Individuals and beneficiaries are eligible to get involved in the GUIDE Design and the ACO REACH Design. For the rest of CY 2024, ACO REACH will not consist of the Dementia Care Management Payment (DCMP) or Reprieve Service claims in the REACH ACOs' overall cost of care expenditures or computation of shared savings/shared losses.

Overlapping participants ought to follow GUIDE billing assistance as set forth listed below. GUIDE Respite Service claims will not count towards ACO expenditures, shared savings, or benchmarking in 2025 and for the duration of the GUIDE Model.

Since January 1, 2025, GUIDE Participants also taking part in ACO REACH must cease billing the Medicare Doctor Charge Set up Solutions included under the DCMP (See Display 5 in the GUIDE Payment Approach Paper (PDF)). Participants taking part in both models must follow the GUIDE billing requirements in the GUIDE Involvement Contract and GUIDE Payment Method Paper.

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The GUIDE Participant need to not bill Medicare separately for the services provided in the extensive evaluation. The comprehensive evaluation (and any re-assessments) is covered by the DCMP. If CMS determines the beneficiary is not qualified for the GUIDE Design, the GUIDE Participant can bill for a suitable Medicare-covered expert service that corresponds to the services rendered.