Givers Health Update May 2024: Dementia GUIDE, New Team Members, Policies & More

Hi all,

Hope everyone is enjoying spring! Givers Health has been accepted into Medicare's Dementia GUIDE program as a Partner Organization! This 8-year program provides a per-beneficiary-per-month reimbursement for comprehensive dementia care. Through pre-arranged revenue share agreements, we will be the training partner organization for GUIDE providers.

We also have some incredible new team members, are excited by new policy tailwinds, and are getting good learnings from current customers. More below.

Medicare's Dementia GUIDE program acceptance

We have been tracking Dementia GUIDE since Centers for Medicare & Medicaid Services (CMS) announced it in mid-2023. This is one of two major moves that CMS has made to increase reimbursement for family caregiver training & support. We co-applied to Dementia GUIDE with provider partners and learned in early April that we were accepted! Our solution is especially well-positioned for Dementia GUIDE because of our customized, care-plan-based training.

The program launches in July 2024 and per-beneficiary-per-month payments start in July 2025 for new programs. We can provide our caregiver training & support solution to any GUIDE participant and would love any referrals to other participating organizations who want a thoughtful, differentiated solution in this area. Since caregiver training & support has been an area of past under-investment, we believe it’s the best way to drive differentiated performance in GUIDE. Please reach out to me if you or a colleague is interested in learning more. 

New team members

After a robust evaluation period, we're excited to be welcoming Vincent Cardillo as a new co-founder and CTO! Vincent has held various engineering leadership positions at Square, One Medical, and New Relic. He's passionate about the positive impact that we can bring to patient/caregiver quality of life and growing the caregiver workforce.

Rebecca Hoden, a Doctor of Nursing Practice and Registered Nurse (RN), has also joined us as VP Clinical Operations & Caregiver Learning after a long consulting relationship. Rebecca brings 20 years of experience in education, hospice, and community-based care. She is leading our team of clinical experts to develop training content, validate caregiver skills, and respond to caregiver questions.

Highlighting our work in PACE

PACE continues to be a strategic market for Givers Health. In our work underway with a PACE organization in Northern California, we’re meeting a high need for caregiver training in addressing common behavioral health topics like resistance to care, substance use, depression & anxiety, and patient-caregiver communication. Our expert-supported, adaptive training is building individual and community readiness that helps keep older adults in the community longer. We’re also directly increasing compensation for family & home caregivers, improving the sustainability of their role. We’re excited to be part of the ‘PACE miracle’ with these complex populations, and look forward to applying insights to new PACE sites.

Policy tailwinds we’re keeping an eye on:

• CMS TEAM model: In April, CMS revealed the new TEAM model, a mandatory 30-day episode-based payment for hospitals starting in January 2026 that will be an evolution and replacement of existing bundled payment programs (BPCI and CJR). Around 25% of hospitals in the US will be required to participate in this program. There are 5 surgical episodes that fall within TEAM, including hip/knee replacement and hip fracture, which we have direct experience with. They expect to add more conditions over time. Our family caregiver program for hospital discharges in these episodes aligns well with the incentive structure for TEAM, and we’re excited to talk more with hospitals about it.  

• Duals Act: The Duals Act would require every state to establish an integrated Medicare/Medicaid plan. It also requires that every state allow PACE (Program for All-Inclusive Care for the Elderly) to be offered, increases frequency of PACE enrollment, and reduces the cost barrier for Medicare-only PACE participants by allowing them to enroll in Medicare Part D. This would further fuel the growth of D-SNPs and PACE organizations, two or our target customer groups. 

Introduction Asks: 

• People with ESRD C-SNP or dialysis-at-home experience: We are interested in talking with people who have experience in ESRD C-SNP’s, ESRD value-based care, and dialysis-at-home as we explore potential to support dialysis care partners. A few include:

  • Paul Mikulecky at Elevance

  • Raj G at Optum 

  • Morgan Poole at Optum Home

  • David Firdus at Gold Kidney Plan 

• Dementia GUIDE providers: We are excited to be a Partner Organization for caregiver training & support, and want to support other organizations who are participating and may not have expertise in the caregiver support & training area. We’ll be able to see a list of participants for specific intros soon, but in the meantime would welcome connections to clinical organizations that have been accepted.

• Consultant with home care / personal care administration expertise: We’re looking for a consultant with expertise on setting up and running home care organizations in California, ideally ones that have contracted with Medicaid. Let me know if you have any suggestions!