New recommendations from Alliance to Improve Dementia Care seek to incentivize care coordination, improve access to high-quality care, and reduce disparities by testing value-based payment models
Washington, D.C. – November 10, 2021 – The growing prevalence of dementia creates an urgent need to reform care delivery and payment policies under traditional Medicare, according to a report released today by the Milken Institute Alliance to Improve Dementia Care. The report, “Scaling Comprehensive Dementia-Care Models,” outlines recommendations the Milken Institute developed in collaboration with leaders across industry, government, research, advocacy, philanthropy, community-based organizations, and health systems.
The report recommends widely testing the implementation of payment models for comprehensive dementia care in traditional Medicare, especially in underserved communities. This recommendation is consistent with the bipartisan Comprehensive Care for Alzheimer’s Act (S. 1125; H.R. 2517), which calls on the Center for Medicare & Medicaid Innovation (CMMI) to test an alternative payment methodology for dementia-care management.
“Having cared for parents with Alzheimer’s, I understand the difficulties that caregivers face and the significant costs involved,” US Senator Shelley Capito (R-W.Va) said. “A dementia care management model, such as the one outlined in the bipartisan Comprehensive Care for Alzheimer’s Act, could have helped both me as a caregiver by helping to coordinate the care my parents received, and my parents by ensuring that they were receiving the best possible care. With thousands of West Virginians currently living with dementia, it’s important that we pursue solutions like this legislation to help ease the burden on patients, caregivers, and health programs.”
“Our current health care system can be extremely difficult for those living with dementia and their caregivers to navigate,” said US Representative Brian Higgins (D-NY). "We need new approaches so patients can get the best care to improve their quality of life as they live with diseases that are debilitating. This is especially important for patients with dementia, whose care is often labor intensive and emotionally demanding for their caregivers.”
Report recommendations center on the following themes:
Related to these themes, the Alliance recommends the five following solutions:
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Integrate medical and social services to support people with dementia and their caregivers.
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Expressly link equity measures to outcome measures to hold providers accountable for racial, ethnic, and geographic disparities.
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Expand training for all workers involved in dementia care.
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Change how Medicare pays for dementia care to incentivize care coordination across the continuum of care.
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Improve payment to community-based organizations for the supportive services they provide.
“The fragmented nature of traditional fee-for-service Medicare presents multiple obstacles to delivering high-quality, coordinated, and comprehensive care to people diagnosed with Alzheimer’s disease and related dementias,” said Nora Super, Executive Director, Alliance to Improve Dementia Care. “No current payment structure pays for all of the needed elements of dementia care. CMMI should test an alternative payment model for dementia-care management. If implemented, the Alliance to Improve Dementia Care believes it can improve quality of life, better support caregivers, delay transitions from home to nursing homes, and reduce the total cost of care.”
“Scaling Comprehensive Dementia-Care Models” can be downloaded here.
Media Contact
Chad Clinton, [email protected]
About the Milken Institute
The Milken Institute is a nonprofit, nonpartisan think tank that helps people build meaningful lives in which they can experience health and well-being, pursue effective education and gainful employment, and access the resources required to create ever-expanding opportunities for themselves and their broader communities. For more information, visit https://milkeninstitute.org/.
About the Alliance to Improve Dementia Care
The Alliance to Improve Dementia Care brings together a multi-sector coalition of leaders to advance timely detection, access to treatment and coordinated care, and health equity for people at risk for and living with dementia and their caregivers. Through expert workgroups, convenings, and collaborative initiatives, the Alliance amplifies and promotes the adoption of proven solutions and promising innovations. For more information, visit https://milkeninstitute.org/alliance.
