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A 3 a.m. phone call to a dementia helpline turned Sharon Hall into a champion for a new Medicare pilot program called GUIDE. She is the primary caregiver for her husband, Rod Hall, 72, who

was diagnosed a decade ago with dementia, which affects memory, thinking and the ability to do tasks of daily living. She’s called that helpline a couple of times, including at 3 a.m.

“That’s what keeps you out of the hospital,” says Hall, of Suwanee, an Atlanta suburb. “He fell out of the bed and hit his head. Do we go or don’t we go to the hospital? I’m able to call

24/7 and know I will have a nurse practitioner who has [Rod’s] records, even if it’s 3 o’clock in the morning,” she says. “You may only use it a couple of times in the course of your

treatment, but when you need it, it’s so needed.” Keeping people with dementia safe and avoiding visits to the hospital are among the goals of GUIDE (Guiding an Improved Dementia

Experience), a pilot program launched last July by the Centers for Medicare & Medicaid Services. Of 390 programs that CMS approved for GUIDE, 96 were already operating; they began the

pilot in July 2024. Today, 93 of those are still operating. They include large academic medical centers, hospital health systems, small group practices, community-based organizations and

hospice agencies. The program expansion, scheduled for July 1, includes an additional 278 providers approved by CMS. Atlanta’s Integrated Memory Care at Emory (a joint effort of Emory

University and Emory Healthcare) is one of the pilot centers, and it’s where Rod Hall receives both primary and dementia care. GUIDE also provides up to $2,500 each year for respite

benefits, which can pay for in-home caregivers, overnight respite care or adult day care so caregivers can take a break. Hall says paying out-of-pocket for respite care got too expensive for

her — until GUIDE started pitching in. “Even a day center … becomes very cost prohibitive,” she says. “A couple of years ago, he was going to a day center two days a week. That was the

minimum and it was like $85 a day.” HELP FOR CAREGIVERS For the Halls and others in the same situation, GUIDE’s eight-year pilot aims to improve the quality of life for people with dementia

and their unpaid caregivers. In addition to the helpline, families are assigned to a care “navigator” to help them find local services, such as meals and transportation. They also can get

education and training. For health care providers, the GUIDE model incentivizes delivery and expansion of coordinated, high-quality and cost-efficient care.  “The ultimate goal is that this

works, saves Medicare money, improves the lives of people with dementia and their caregivers and keeps people out of nursing homes,” says David Reuben, M.D., a geriatrician and the program

director for GUIDE at UCLA Health in Los Angeles. Research by Reuben and others published in 2019 in _JAMA Internal Medicine_ and 2020 in the _Journal of the American Geriatrics Society_

shows that coordinating care and support for caregivers and their loved ones with dementia can lower Medicare costs while reducing emergency department visits, shortening hospital stays and

delaying admission to long-term care.