Bay Aging, the Area Agency on Aging for Virginia’s Middle Peninsula and Northern Neck, has partnered with Embrace Prevention Care, a provider of telehealth dementia services in multiple states, to bring Medicare’s Guiding an Improved Dementia Experience (GUIDE) Model to the region. This collaboration is part of a nationwide initiative led by the Centers for Medicare & Medicaid Services (CMS), involving 330 organizations, to deliver comprehensive, high-quality dementia care at no cost to patients or caregivers.
Launched in 2024, the GUIDE Model is a national, 8-year dementia care Medicare program focused on improving quality of life, reducing caregiver burden, and preventing hospital and long-term care utilization by delivering a standardized, team-based approach to dementia care. At no cost to the dementia patient and family, eligible Medicare Part A/B participants receive personalized care planning, coordinated care from their existing doctors, specialists, and social care services, caregiver education, training, and support, 24/7 access to team members or helplines, and up to $2560 in annual respite support.
As one of only five Area Agencies on Aging (AAAs) selected to participate nationwide, Bay Aging is currently enrolling qualified Medicare beneficiaries with dementia in GUIDE services. Through its statewide platform VAAACares®, Bay Aging is partnering with Embrace Prevention Care to offer Virginia AAAs a turnkey model to implement GUIDE care across Virginia.
Embrace Prevention Care currently provides GUIDE Model services in 6 states using local Nurse Practitioners as care navigators. The new partnership enables Embrace to work with local AAAs to enroll people into GUIDE services in expanded areas – providing GUIDE social care services that align with the AAA’s capabilities and goals. Highly integrated health and social care ensures that the patient’s needs are served by the best available local service providers.
Kathy Vesley, President & CEO of Bay Aging, said, “We believe AAAs across the nation can serve as vital partners in delivering GUIDE dementia care. Bay Aging’s model offers community-based agencies the ability to provide the social care components of GUIDE to support families facing the challenges of dementia. We look forward to working with AAA colleagues in Virginia and other states to improve the quality of life for people living with dementia and their caregivers.”
This collaboration combines Bay Aging’s experience in community-based services and established infrastructure with Embrace Prevention Care’s telehealth expertise and clinical team, creating a seamless integration of health and social care. Together, they aim to deliver scalable impact by rolling out the GUIDE Model across Eastern Virginia and supporting expansion through Area Agencies on Aging statewide. Most importantly, the partnership ensures comprehensive, no-cost care for patients, including interdisciplinary coordination, therapeutic support, medication oversight, and caregiver respite—all fully covered under Medicare.
About Bay Aging:
Bay Aging is a 501(c)(3) nonprofit serving over 36,000 residents annually across Virginia’s Middle Peninsula and Northern Neck. Since 1978, Bay Aging has provided essential services (transportation, housing, health, and community support) that allow individuals of all ages to live independently in their homes. Supported by the Bay Aging Foundation, the organization remains committed to sustaining these vital programs for future generations. To contribute, visit bayaging.org/support.
About Embrace Prevention Care:
Embrace has provided preventive telehealth care to older adults for four years and now brings the same geriatric preventive care model to dementia patients through GUIDE. With a team of certified nurse practitioners, social workers, and pharmacists, Embrace supports patients and caregivers to improve outcomes, reduce hospital days , and enhance quality of life.
For more information, please contact:
Bay Aging
Kathy Vesley, President & CEO
804-758-2386
kvesley@bayaging.org
www.bayaging.org
Embrace Prevention Care
Marty Agather
952‑334‑5150
Marty.Agather@EmbracePreventionCare.com
www.embracepreventioncare.com