PocketRN, Modivcare team up on Medicare dementia care pilot

PocketRN and Modivcare are forming a national partnership to test CMS’s GUIDE dementia care model, which aims to improve coordination, caregiver support and access to respite services for people living with dementia. The effort comes as the federal program scales nationwide after launching in 2024.

Why it matters: - The partnership targets a growing care gap for people living with dementia and the family caregivers who support them at home. - The CMS GUIDE model is designed to improve care coordination, expand access to support services and test whether respite care can help families delay or avoid facility care. - Modivcare’s home-care footprint gives the effort reach across multiple states and care settings.

What happened: - PocketRN and Modivcare announced a national strategic partnership to test the Centers for Medicare & Medicaid Services dementia care model. - PocketRN will participate as one of nearly 400 organizations building Dementia Care Programs under the CMS Guiding an Improved Dementia Experience model. - The announcement was made Oct. 6, 2026, in Washington. - The GUIDE model launched July 1, 2024.

The details: - The GUIDE model tests a new payment approach for supportive dementia services. - Covered services include comprehensive person-centered assessments and care plans, care coordination, 24/7 access to an interdisciplinary care team member or help line, and certain respite services for caregivers. - Patients and caregivers will also have access to a Care Navigator. - The Care Navigator will help people connect to clinical and non-clinical services such as meals and transportation through community-based organizations. - Modivcare said the deal reflects the fact that a significant share of its client base has a dementia diagnosis. - Modivcare subsidiaries involved in daily care and respite support include All Metro Health Care in New York and Florida, A&B Homecare Solutions in Connecticut, CareGivers America in Pennsylvania, Carefinders Total Care in New Jersey, Panhandle Support Services in West Virginia, Multicultural Home Care in Massachusetts, Freedom Home Care in Massachusetts and Independence Healthcare Corp. in Massachusetts. - PocketRN says its Nurse for Life model gives patients and families ongoing access to a dedicated nurse at no cost to them. - PocketRN said the partnership will also support education and training for caregivers on best practices for caring for a loved one with dementia. - More information on the CMS GUIDE model is available from CMS.

Between the lines: - The partnership combines virtual nursing with in-home personal care, creating a care model that follows patients across settings. - The focus on respite suggests policymakers and providers are treating caregiver burnout as a core issue, not just a side effect of dementia care. - The pilot also tests whether better navigation and coordination can reduce pressure on families before they reach a crisis point.

What's next: - PocketRN and Modivcare will begin delivering services under the GUIDE framework. - CMS will use the model to evaluate whether the payment approach improves support for patients and caregivers while encouraging more care at home. - The companies said the program could help caregivers continue supporting loved ones at home longer.**