Something is afoot at the Centers for Medicare & Medicaid Services. For those advocating for family caregivers, it is beyond exciting.

The development that is flooring close followers of healthcare public policy is the recognition that unpaid caregivers have a place in the medical reimbursement system. Specifically, two notable policy changes occurred recently — one in the proposed physician fee schedule and another in a new dementia care model housed at the Center for Medicare and Medicaid Innovation. The proposal in the physician fee schedule would, for the first time, pay doctors and other practitioners for training family caregivers. Five specific codes would cover this reimbursement. Patient conditions that would warrant family caregiver training could include various forms of dementia, stroke or traumatic brain injury.

The meaning of this proposal cannot be understated. Family caregivers have been doing such work without recognition forever. To receive formal training is a nod to the understanding that these people (who likely will care for their loved ones whether they are trained or not) could use a hand.

The other development that is heartening for family caregivers appears in the Guiding an Improved Dementia Experience (GUIDE) Model. A provision in the model, which will launch next July, allows participants to bill for respite services for beneficiaries with a caregiver, up to an annual respite cap amount.

Anyone who understands family caregiving knows about the strain the obligation places on caregivers mentally, physically and emotionally. Respite care is critical for these workers.

Tyler Overstreet Cromer, who heads the Medicare Innovation team for ATI Advisory, a healthcare research and advisory services firm, put the two policy moves in perspective.

“I’m seeing what I would call a real shift in how policymakers are thinking about the role of family caregivers, sort of vis a vis the medical reimbursement system,” she told McKnight’s Home Care Daily Pulse.

These regulatory steps may not seem like big moves to people steeped in the work of family caregiving without pay and often without recognition. But they are, without a doubt, both welcome and overdue.

Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].