The dementia dyad is the segment that most rewards LEAD-era investment.
For ACOs, innovation units, and health-system leaders preparing for LEAD, GUIDE, and the ACO REACH successors, the dementia-plus-caregiver population is the shared-savings opportunity with the clearest evidence base and the highest unit economics. Dyad Health is the dyadic-care delivery partner built for that moment.
Why dementia, why now
Three things are converging for provider-side organizations.
LEAD Model begins 2027
The Medicare shared-savings program that succeeds ACO REACH begins January 1, 2027, with a ten-year horizon through 2036. Dementia patients are the single cohort with the highest per-member cost variance — which means the highest shared-savings upside for ACOs that can compress it.
GUIDE pays for the care
CMS's GUIDE Model reimburses comprehensive dementia care (navigation, 24/7 access, caregiver education, up to $2,500/year in respite) for eight years. Health systems and ACOs can participate in GUIDE and use Dyad as their delivery partner; under LEAD, GUIDE per-beneficiary payments layer underneath the ACO's shared-savings upside.
Caregiver support is now visible
CMS has made family caregivers a distinct programmatic priority. Under the new interoperability rules, caregiver encounters — assessments, respite utilization, education — are first-class data, not background. Measured rigorously for the first time.
How Dyad fits into an ACO
Dyad is a delivery partner, not a technology vendor. The ACO holds the risk contract; Dyad delivers the care to the dementia-plus-caregiver segment.
- Segment identification. Using the ACO's data, we identify the dementia-plus-caregiver dyads likely to drive the next quarter's hospital admissions.
- In-home and community delivery. Navigators work with each family in their language, in their home. A dementia specialist is available within days. Respite is scheduled proactively.
- Documentation back to the ACO. Through FHIR, the ACO's providers see what we see — conditions surfaced in home visits, medication issues caught before the ED, caregiver burden measured and trending. RAF accuracy and Star Ratings move on the same visibility loop, without adding clinical workflow.
- Shared-savings measurement. Every contract is measured on the ACO's own numbers, on the ACO's own dashboard.
Who this is for
Dyad is built for:
- NAACOS-member ACOs preparing a LEAD or LEAD-adjacent strategy
- Health systems running GUIDE or considering GUIDE participation
- Innovation units and payvidor-adjacent organizations who see the dementia-plus-caregiver cohort as the first target of a broader dyadic-care capability
If any of those describe you, we'd like to talk. We're already contracting for 2027 enrollments.