Healthcare providers wary CMS dementia pilot will not cover costs

Healthcare providers wary CMS dementia pilot will not cover costs
Modern Healthcare; by Diane Eastabrook; 7/23/24
Hospitals, primary care practices and other healthcare providers are split over whether Medicare will pay them enough to cover dementia patients at home as part of a new pilot. Nearly 100 providers began enrolling patients July 1 in the Centers for Medicare and Medicaid Services’ Guiding an Improved Dementia Experience model, known as GUIDE. Another 300 others will begin enrolling patients in the program on July 1, 2025. Some participants that previously provided comprehensive wrap-around services for dementia patients at home said getting a monthly care management payment for each fee-for-service beneficiary will cover costs they had been absorbing. But others aren’t sure the reimbursement will be enough to scale up programs or cover the cost of care for these complex patients.