Isaac Health’s GUIDE Program for LTSS plans
Comprehensive dementia care & family support for unaligned members
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.
What is the GUIDE Program?
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.
Overview The GUIDE Program covers the entire member care journey, from diagnosis to ongoing care management
Personalized care planning
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.
Dedicated care navigation
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.
24/7 support line
Families enrolled in the GUIDE program have access to a 24/7 support line that provides timely assistance for urgent questions or care concerns.
Respite services for caregivers
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.
Caregiver education and support
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.
Comprehensive care management
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.
Additional services
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.
Comprehensive dementia care and family caregiver support – at no cost to your organization
Significant Medicaid savings
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.
No cost to your plan
The GUIDE Program is fully funded by CMS, meaning that all medical services, care navigation, and caregiver support are covered by Medicare, not Medicaid.
Quick and seamless implementation
Launch in under 60 days with a streamlined onboarding process and minimal operational lift. We handle member outreach, screening, care coordination, and ongoing reporting.
Stats
- 0% of members reported improved neurocognitive health over the course of 6 months
- 0% of members in cognitive rehabilitation therapy reported improvement against their cognitive goals in only 3 weeks
- 0% reduction in emergency department visits for members living with dementia
- 0% reduction in hospital days for members living with dementia
Testimonials
My wife is in her third year of Alzheimer's. Until we found the GUIDE Program and contacted Isaac Health, there was no real help from any medical entities we reached out to. Since enrolling in the program through Isaac Health we have received exceptional assistance both for my wife with her Alzheimer's and myself as her caretaker. I can honestly say I don't know where she and I would be today if I had not enrolled with them and received the physical and psychological help they have given us. This is a godsend of a program.
GUIDE Caregiver
Resources
February 05, 2026
Evaluating the Isaac Health GUIDE Model in Practice
Read More](https://isaac.health/evaluating-the-isaac-health-guide-model-in-practice/)
July 08, 2025
One year into GUIDE: Reflections on a trailblazing dementia program that puts patients and caregivers at the center
Read More](https://isaac.health/reflections-on-guide/)
January 28, 2026
Isaac Health Partners with NYU Langone Health to Broaden Access to Expert Brain Health and Memory Care
Read More](https://isaac.health/newsroom/isaac-health-partners-with-nyu-langone-health-to-broaden-access-to-expert-brain-health-and-memory-care/)
Let’s explore GUIDE for your members
Book a meeting with us to discuss how Isaac Health’s GUIDE Program can support your unaligned population.