Alzheimer's Foundation of America

Foundation of America

Alzheimer’s Foundation of America Proposes Recommendations to Increase Healthier Outcomes, Delay Placements in Nursing Home Settings

People Living with Alzheimer’s Hospitalized 2-3 Times More Often as Others the Same Age; More Than Half of All Nursing Home Residents Have Alzheimer’s

NEW YORK (March 21, 2019)—In anticipation of Alzheimer’s disease (AD) rates tripling to nearly 14 million by 2060, the Alzheimer’s Foundation of America (AFA) has submitted five legislative proposals to the Senate Committee on Health, Education, Labor and Pensions (HELP) to improve the quality of care to persons living with AD and dementia and possibly even delay placement into long term nursing home settings.

“AFA believes that the adoption of person-centered, coordinated care delivery models and the expansion of care partner training—including specialized dementia care training—will help increase healthier outcomes for diagnosed individuals andtheir care partners, who also take on a significant burden,” said Charles J. Fuschillo, Jr., President and CEO of AFA. “What’s of utmost importance to millions of families? More quality care for their loved ones and more time
with them.”

In a letter written to Senator Lamar Alexander, HELP Committee Chair, and Senator Patty Murray, Ranking Member, in response to a call for proposals to increase health care efficiencies, AFA reported that, unfortunately, individuals living with Alzheimer’s disease use a disproportionate amount of health care resources compared to people with other diseases. One factor attributable to the intensity of service are the comorbidities that many with Alzheimer’s disease have. These conditions complicate the delivery of care and require the need for multiple providers. People with Alzheimer’s are hospitalized two to three times as often as people the same age who do not have the disease. Similarly, more than half of all nursing home residents have Alzheimer’s disease.

AFA estimates that if adopted in totality, the following five legislative proposals, which focus on person-centered care, would increase care quality and could potentially deliver more than $110 billion in federal health cost savings over 10 years by delaying the need for placements in nursing home settings. These proposals include:

Expanding care delivery through medical homes to beneficiaries with Alzheimer’s disease. Patient-centered Medical Homes (PCMH) are a care model that aims to address all patient needs, delivering care that is coordinated, comprehensive, efficient and personalized.

Expanding the Independence at Home (IAH) care delivery model to all qualified Medicare beneficiaries living with dementia. The IAH model reduces hospitalization and institutionalization by using primary care teams led by physicians or nurse practitioners to deliver timely, in-home primary care to Medicare beneficiaries with multiple chronic illnesses and functional impairments, including those living with dementia.

Incentivizing dementia-specific protocols for all U.S. hospitals. Protocol training will help hospital staff recognize, respond to and communicate with individuals who have dementia, including providing tools and best practices to manage behaviors and wandering. These protocols are designed to prevent unnecessary admissions, avoid unnecessary testing and shorten hospital stays.

Extending appropriations for Community-based Care Transitions Programs (CCTP) and targeting this program more widely to those living with dementia. Community-based Care Transitions Program (CCTP), created by Section 3026 of the Affordable Care Act, tested models for improving care transitions from the hospital to a less costly care setting and reducing readmissions for high-risk Medicare beneficiaries.

Supporting incentives and other mechanisms to further Medicare and Medicaid implementation of Program of All-Inclusive Care for the Elderly (PACE) for beneficiaries living with dementia. PACE programs are community-based healthcare programs created for people 55 and over who require nursing-home-level care, but prefer to receive it in their own familiar surroundings, like their home. As of 2018, 233 PACE locations exist in 31 states. Almost half of PACE enrollees have a dementia diagnosis.

Alzheimer’s disease is reaching epidemic proportions. More than 5 million people are living with the disease and that number is expected to nearly triple by 2060, according to the Centers for Disease Control and Prevention. Until a cure is found, AFA believes those living with dementia and their care partners should have access to person-centered care models that include specialized dementia training to ensure better outcomes.