What are GUIDE Alerts?
Pearl GUIDE alerts identify patients who may be eligible for and benefit from the new CMS program, GUIDE (Guiding an Improved Dementia Experience). GUIDE aims to enhance the quality of life for dementia patients and alleviate caregiver burden by offering comprehensive services at no cost to the patient.
Why it Matters
People with dementia frequently experience fragmented care due to multiple chronic conditions, resulting in high hospitalization and emergency department visit rates. GUIDE services can improve health outcomes through comprehensive care coordination.
Who is Eligible for GUIDE?
Our algorithm considers factors such as:
ICD-10 or HCC code indicating potential dementia
Frailty diagnosis within the last 12 months
No history of hospice
No established relationship with a neurologist
Other factors
Recommended Action
Review the patient’s history and diagnoses
Consider enrolling the patient in GUIDE services through a Pearl partner vendor
Platform Priority
Do Now or Do Next, depending on the patient’s acuity