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Alzheimer's Association outlines CMS 'GUIDE' care-navigation model and training supports for Tennessee providers
Summary
Liz Hall of the Alzheimer's Association briefed the council on CMS's GUIDE model — an eight-year pilot offering bundled payments for care navigation — and described Association resources and training to help Tennessee providers meet GUIDE requirements; she noted eligibility is limited to traditional Medicare Part B billers and Tennessee providers can start enrolling July 2025.
The Alzheimer's Association presented an overview of CMS's GUIDE model and the resources it is preparing to help Tennessee providers deliver comprehensive care navigation.
Liz Hall, the Association's health systems director, said GUIDE (a CMS/CMMI model) provides a bundled payment for care navigation for people with Alzheimer's and related dementias and their caregivers. "The program provides a bundled payment for providing care navigation for patients with Alzheimer's or related dementia and their caregiver," Hall told the council.
Hall summarized the model's nine criteria, including 24/7 access to support, care coordination and transitional care management, caregiver education and a required comprehensive home visit. She highlighted a key provider challenge: participants must have contracts that allow home-based respite rather than only facility-based respite.
Tennessee providers are on a new track and cannot begin enrolling patients in GUIDE until July 2025, Hall said. She added eligibility is limited to Part B Medicare billers on traditional Medicare, not Medicare Advantage. "You must be on traditional Medicare to be able to be enrolled in the GUIDE program. You can't be on Medicare Advantage," she said.
The Alzheimer's Association has developed guiding principles, training curricula (including a certification program and a Project ECHO for navigators) and materials that can be used whether or not a provider enrolls in GUIDE. Hall said the Association will share resources and training plans with Tennessee partners and that some training components will count toward GUIDE requirements.
Council members asked whether the Association's materials could be adapted for Medicaid and Medicare Advantage populations; presenters said the resources are broadly useful but noted billing and contracting requirements differ for other payers. The presentation closed with an offer to share toolkits and training schedules with the council's partners.
