How Lower Cape Fear LifeCare Built its Memory Care Affiliate

Lower Cape Fear LifeCare built from the ground up a program dedicated to serving dementia patients.

A growing number of operators have developed programs tailored to patients with specific diagnoses, providing specialized care tailored to their specific needs. Examples include dementia, heart failure and other cardiac conditions, as well as diseases of the lungs.

At Lower Cape Fear LifeCare, the program started small and rapidly expanded. The North Carolina-based hospice provider six years ago launched a support group for dementia caregivers, called Memory Partners. This over time bloomed into a full-fledged dementia services subsidiary called LifeCare Memory Partners, Evan Dressel, director of strategy, development and innovation at Lower Cape Fear LifeCare said at the Hospice News ELEVATE conference in Orlando, Florida.

“We recognized that there was a significant caregiver burden in that dementia space, and we decided to actually do something about it,” Dressel told Hospice News. “In addition to the care that our hospice team was providing, we decided to form a caregiver support group. That was really how our program started, as a program within our hospice organization. Now we didn’t do any external marketing for this program, but it just grew like a hockey stick in terms of the growth over the last few years.”

Lower Cape Fear LifeCare is a nonprofit hospice, palliative care and memory care provider headquartered in Wilmington, North Carolina, serving 10 counties in its home state and the Myrtle Beach area of South Carolina. The organization serves a combined census of 1,400 patients daily.

Health care providers can expect an influx of patients with dementia-related conditions in the coming years.

Nearly 6.7 million seniors in the United States have been diagnosed with Alzheimer’s or other dementias, according to a 2023 report from the Alzheimer’s Association. By 2050, this is expected to nearly double to 12.7 million people.

During the early years of the Memory Partners program, Lower Cape Fear LifeCare funded the program through a grant from the Administration for Community Living (ACL), a sub-agency to the U.S. Department of Health and Human Services. Recent cuts by the Trump administration have since shuttered that agency.

As the grant dollars were set to expire, the organization began to consider ways to make it sustainable in the long term, Dressel said. The result was the formation of the LifeCare Memory Partners subsidiary.

“We needed to figure out our sustainability plan. So part of that plan was actually forming a new nonprofit entity that would house our dementia care program. We have an organization called LifeCare memory partners, dedicated to providing dementia care for both caregivers and patients who are living with dementia,” Dressel said at ELEVATE. “In addition to, again, providing that end-stage dementia care, we are also providing early- and mid-stage care.”

LifeCare Memory Partners is participating in the U.S. Centers for Medicare & Medicaid Services’ Guiding an Improved Dementia Experience (GUIDE) payment model, implemented last year.

The payment model is designed to improve quality of life for dementia patients and their caregivers by addressing care coordination, behavioral health and functional needs. While the model does not use the term “palliative care,” it does incorporate principles and practices traditionally associated with those services, such as interdisciplinary care and caregiver support, among others.

When the program was announced last year, CMS indicated to Hospice News that opportunities exist for hospice and palliative care providers within the model. Many of those providers agree. More than 40 hospice- and palliative care-specific organizations are participating in the model, according to CMS.

Also participating in the model are primary care operators that also offer palliative care. All told, nearly 400 health care organizations are developing Dementia Care Programs (DCPs) to potentially serve hundreds of thousands of Medicare beneficiaries nationwide, CMS stated in a fact sheet.

Reimbursement through the model includes a per-member, per-month payment, as well as an infrastructure payment for some safety net providers. Participating operators may also receive payment for respite care.

LifeCare Memory Partners works with its referral sources to identify patients who could benefit from their program, which is designed to help dementia patients remain in their homes for as long as possible.

Patients aligned with the program receive a suite of services designed to support dementia patients and their caregivers. Caregiver support is an integral part of the model.

“If anyone here has experienced Alzheimer’s or dementia in any form, or knows anyone who has, you’re surely aware of the extreme burden that’s placed on caregivers. So CMS came out with this respite benefit as part of the GUIDE model that requires us as a participant to offer in-home respite as the first option, and then we’re also allowed to offer adult day respite and overnight respite,” Dressel said. “We’re contracting with different partners to help us execute on those components of the model right now, with the intent of building out our own dementia focused home care agency in the future that will really help us care for the more critically ill folks and the folks that are a little further along in their journey.”