New group names 4 things US healthcare can—and should—handle on behalf of Alzheimer’s patients, caregivers
Alzheimer’s disease already has U.S. healthcare in a crisis of care capacity, and the pressure to do more in response is mounting.
The numbers predict the storm to come. More than 7 million Americans are currently living with Alzheimer’s. The national care expenditure tops $380 billion per year.
The patient count will nearly double by 2050. With that, the costs will come close to reaching $1 trillion.
What’s more, the true total cost is hard to estimate since so many Alzheimer’s caregivers are family members and other unpaid volunteers.
It is with this scenario in mind that the new, nonprofit Alzheimer’s Policy Working Group has produced a set of action priorities.
The group launched in January to tap the clinical expertise and strategic opinions of physicians—specialists as well as primary care providers—who have direct experience treating patients with dementia.
The action items are laid out in a 16-page report. Among them are four realizable recommendations for healthcare stakeholders in various spheres of involvement.
1. At the first signs of cognitive impairment, PCPs should encourage lifestyle changes and discuss interventions that can preserve and even improve cognitive function.
This includes nutritious diet, regular exercise, better treatment of vascular risk factors such as hypertension, high cholesterol and diabetes, brain training, social activity and hearing aids—all of which hold the potential to improve quality of life for patients and families, the working group notes.
“The earlier these changes happen, the greater the chance of benefit,” they add.
2. The Centers for Medicare and Medicaid Services (CMS) and American Medical Association should adopt billing codes that enable timely diagnosis of cognitive impairment and Alzheimer’s disease in primary care settings.
This includes updating CPT or HCPCS code descriptions to support the use of new and emerging technologies like digital cognitive assessments, the authors maintain.
At a minimum, they emphasize, these organizations should:
- Establish clear guidance to show that the clinical work required to bill for services using the 99483 CPT code—a commonly used code to cover Alzheimer’s diagnostic and care planning activities—is team-based work and should be distributed across multiple clinicians and visits.
- Develop new CPT codes to facilitate reimbursement for digital cognitive assessments and timely, accurate diagnosis.
- Update the CMS-HCC risk adjustment model to add a risk adjustment factor to the ICD-10 diagnostic code for mild cognitive impairment (G31.84).
3. Leading medical societies should create a certification that can enable nurse practitioners and physician assistants to obtain the training needed to diagnose Alzheimer’s and manage patients at all stages of the disease.
This should include the American Academy of Neurology, American Association of Nurse Practitioners, American Association of Physician Assistants, American Academy of Family Physicians, American Geriatric Society, American Association for Geriatric Psychiatry, Society of General Internal Medicine and other relevant professional societies, the group states.
“Doing so will accelerate the use of team-based care in health systems and private practices.” The report includes an example of this approach in action at the University of Washington, where clinicians “doubled the number of patients diagnosed with mild cognitive impairment in primary care in nine months.”
4. Healthcare systems should establish brain health programs that empower administrators with knowledge of the total revenue associated with Alzheimer’s care.
This should include revenue from testing, imaging, treatment and other services that form the Alzheimer’s care pathway in a particular healthcare system, the authors write.
“Some philanthropic initiatives are demonstrating how these new care pathways can facilitate billable revenue streams to improve patient care and health system efficiency,” they add.
The working group calls for the development of “best practices for creating scalable care pathways” that healthcare systems can readily—and profitably—adopt.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.