Healthcare services · Dementia care

Craniometrix

A New York company that set out to catch Alzheimer’s early with a phone game and now runs dementia care navigation paid for by Medicare. It shows up in the federal participant list twice over: as a vendor to neurology practices, and as the trade name of a Florida professional entity that bills the program directly.

The phone calls got shorter

“When I was a kid, my grandma had Alzheimer’s. She was living out in rural India at the time, and slowly, over the phone, she started repeating herself and those types of things,” Nikhil Patel told the Big Picture Medicine podcast in 2022. The family brought her to the United States, where every doctor said the same thing: the diagnosis had come far too late.

Patel was in grade seven. He started trying to build a computer that could catch it earlier. By high school he was a research associate at the University of Central Florida, getting dropped off at the lab by his mother. The company he founded years later does something almost unrelated to that project. It runs caregiver support programs for neurology clinics. The through line is the disease.

What Medicare finally agreed to pay for

For decades the part of dementia care that keeps people at home was the part nobody billed for. The medical visit had a code. The daughter driving over at 3am did not.

That changed on July 1, 2024, when the CMS Innovation Center launched Guiding an Improved Dementia Experience, or GUIDE: an eight-year voluntary model running to June 30, 2032, paying a monthly dementia care management fee across five complexity tiers plus up to $2,500 a year per patient for respite. It launched with 390 participating organizations, and CMS has since said there will be no second application window: the only cycle closed in early 2024. Established programs began billing on July 1, 2024. New programs spent a year in pre-implementation and started on July 1, 2025.

One rule decides what a company like Craniometrix can be. CMS states that “Health care providers eligible to be GUIDE Participants include Medicare Part B-enrolled providers and suppliers, excluding durable medical equipment (DME) and laboratory suppliers, who are eligible to bill under the Medicare Physician Fee Schedule.” A software company is not that. A professional entity with a billing clinician is.

A Yale computer scientist who left the hedge funds

Patel studied computer science and economics at Yale, then wrote trading algorithms at hedge funds and at Goldman Sachs. He went back to the problem when another relative was diagnosed. By August 2022 TechCrunch reported a three-person operation with $6 million in seed funding from Quiet Capital, Defy.vc, Olive Tree Capital, Rebel Fund, J Ventures, Cathexis Ventures and Y Combinator. The product was an app that Patel said could flag Alzheimer’s years before symptoms after ten minutes of gameplay, with a physician signing the report. Forbes named him to its 30 Under 30 Healthcare list for 2023 on the strength of it.

He was 22, and explicit about the route he did not want. Investors kept telling him to build insurance partnerships, or to become the tool inside physician offices. “People give a lot of advice that makes sense through the lens of how medical tooling was done 10 years ago,” he said. He wanted a consumer product, cash pay, straight to the family.

The pivot, and then the second pivot

The company’s own about page dates the turn precisely. “In 2023, we expanded to focus on providers and enabling their success in Medicare’s GUIDE program.” That is the tool inside the physician office, and the insurance relationship, arrived at from the opposite direction.

The design it settled on is a split of labour the company puts in numbers on its own site: care navigators do 55 percent of the work, Craniometrix software 40 percent, the referring clinic 5 percent. Johns Hopkins clinicians supervise, under the MIND at Home model that Hopkins researchers spent fifteen years building and that GUIDE itself drew on. Hopkins lists Craniometrix on its adopters page as “a comprehensive dementia care solution that supports Centers for Medicare and Medicaid Service (CMS) GUIDE model participants.”

Then came the second move, visible only in the federal record. Craniometrix stopped being a supplier to participants and became one. In the CMS list updated August 2026, GUIDE-01043 is a Florida professional limited liability company, Dementia Care FL PLLC, doing business as Craniometrix, registered in Oviedo and approved for thirty states. Two slots later, GUIDE-01045 is Dementia Care Texas PLLC, in The Woodlands, with a website at craniometrix-texas.

What is proven, and what is still claimed

Read plainly: the federal record is unusually good for a company this young, and better than the company’s own marketing suggests. Craniometrix is not merely selling software to GUIDE participants. Through a Florida PLLC it is one, which means it holds the Medicare relationship and the revenue with it. The weak spots sit elsewhere. Two public claims stretch past the documents, the funding history is unverifiable because nothing was ever filed, and there is no evidence of its own that any of it works.

What to watch

• More Craniometrix-affiliated entities in the CMS list. Two slots apart in the numbering suggests the first two were approved together.
• A Form D for the Series A. Nothing under this name has ever been filed with the SEC.
• The 2032 cliff. The model ends June 30, 2032 and no new participants can join.
• CMS evaluation results for GUIDE, which test the hospitalization claim the category rests on.
• Whether the clinic pages that call Craniometrix a Johns Hopkins affiliate get corrected.

In their words

Related companies

• Synapticure: Similar focus. A virtual specialty clinic for ALS, Parkinson’s and dementia, built by an ALS patient and his caregiver
• Darmiyan: Similar focus. BrainSee reads a routine brain MRI and two cognitive test scores and returns a number between 0 and 100
• Serif Health: Similar focus. A company whose whole product is the cleanup of two federal disclosure rules
• Avelis Health: Similar focus. A Y Combinator startup that started by fighting patients’ medical bills, then pivoted to auditing every claim for self-insured employers before the money moves

Sources

1. Public recordGUIDE Model Participant ListCMS · updated Aug 2026
2. Public recordGUIDE Model Request for ApplicationsCMS Innovation Center
3. Public recordGUIDE Model Frequently Asked QuestionsCMS · Sep 22, 2026
4. Public recordGUIDE Model overview pageCMS · Aug 11, 2026
5. Public recordEDGAR searches, zero resultsSEC · Sep 23, 2026
6. Public recordRePORTER searches, zero projectsNIH · Sep 23, 2026
7. IndependentYale alum wants to build a telemedicine platform for Alzheimer’sTechCrunch, Connie Loizos · Aug 10, 2022
8. InterviewDigital Alzheimer’s Detection, episode 094Big Picture Medicine · 2022
9. IndependentNikhil Patel, 30 Under 30 Healthcare 2023Forbes
10. IndependentDetails Emerge About Participants in Dementia Payment ModelHealthcare Innovation · Jul 9, 2024
11. IndependentStartup Seeks to Bring Value-Based Care Approach to DementiaHealthcare Innovation · Oct 11, 2024
12. IndependentCeresti Raises $11.7M For GUIDE-Powered Dementia PlatformHome Health Care News · Aug 19, 2025
13. CollaboratorMIND at Home adopters and collaboratorsJohns Hopkins Medicine · 2026
14. CompanyCraniometrix company profileY Combinator · Sep 2026
15. CompanyCraniometrix about, GUIDE, How it WorksCraniometrix · 2026
16. CustomerCraniometrix GUIDE patient pagesFive neurology practices · 2025 to 2026