Isaac Health partners with LTSS plans to offer the CMS GUIDE Model to unaligned members, helping them access specialized dementia care and caregiver support – at no cost to LTSS plans.
The Guiding an Improved Dementia Experience (GUIDE) Program is an innovative program funded by Medicare. Launched in July 2024, GUIDE is an 8-year payment model designed to support advanced dementia care management, respite care, and caregiver support. Isaac Health is one of the only telehealth solutions selected by the Centers for Medicare and Medicaid Services to offer the GUIDE Program in all 50 states.
Every GUIDE member receives a detailed clinical assessment and a personalized care plan developed by dementia specialists. For individuals who need help with technology, we provide in-home facilitation to support virtual visits.
Members are paired with a dedicated Care Navigator who helps schedule appointments, coordinate services, and ensure patients and caregivers receive the right support at the right time.
Families enrolled in the GUIDE program have access to a 24/7 support line that provides timely assistance for urgent questions or care concerns.
GUIDE caregivers receive access to respite services fully covered by Medicare. Respite services allow caregivers to rest, recharge, and manage personal needs while their loved one receives safe, high-quality care.
We offer dementia caregiver support groups, 1:1 coaching, and educational sessions to help families understand the disease, manage challenging behaviors, and feel confident navigating care decisions.
Our team provides ongoing support with psychosocial needs, assistance with advanced care planning and care transitions, and continual monitoring to help keep patients stable and reduce crises and avoidable hospitalizations.
Beyond GUIDE, Isaac Health provides proactive screening to identify undiagnosed members with dementia or other brain health conditions. We also deliver specialist behavioral health and cognitive rehabilitation services, including therapy, counseling, and complex psychiatric care.
Reduce long-term costs by identifying and supporting members earlier in their dementia journey. Our GUIDE Program helps delay and divert nursing home placement – one of the biggest drivers of Medicaid spend.
The GUIDE Program is fully funded by CMS, meaning that all medical services, care navigation, and caregiver support are covered by Medicare, not Medicaid.
Launch in under 60 days with a streamlined onboarding process and minimal operational lift. We handle member outreach, screening, care coordination, and ongoing reporting.
of members reported improved neurocognitive health over the course of 6 months
of members in cognitive rehabilitation therapy reported improvement against their cognitive goals in only 3 weeks
reduction in emergency department visits for members living with dementia
reduction in hospital days for members living with dementia
Book a meeting with us to discuss how Isaac Health’s GUIDE Program can support your unaligned population.
