A top priority for the Alzheimer’s Impact Movement (AIM) is identifying and implementing ways to provide better care to those living with dementia — such as the Comprehensive Care for Alzheimer’s Act (S. 1125 / H.R. 2517). A new budgetary analysis shows that providing better care as proposed in this legislation will also save Medicare money.
The analysis, commissioned by AIM and conducted by Healthsperien — a health care consulting firm — found that better care through dementia care management would save the federal government nearly $21 billion over 10 years — while also improving the quality of life for individuals living with dementia and their families.
Dementia care management enables individuals to more seamlessly navigate health care and social support systems and to obtain more timely access to care. In 2020, AIM proposed a model that would bring innovation to dementia care, offer a new way to coordinate person-centered care, and address the complex health needs of Medicare beneficiaries with Alzheimer's and other dementias. The key elements of our proposed dementia care management model are:
- Coordinated Care Management: providing patient-centered care management through an interdisciplinary care team of providers that would work collaboratively with a patient’s health care providers and non-medical community-based support services.
- Patient Access: increasing access to care, community-based services, and resources.
- Caregiver Inclusion: ensuring that caregivers, who are an integral part of the care of a person with dementia, participate in the process and are appropriately supported.
- Capitated Payment: paying providers a monthly per-patient fee based on case complexity and an individual’s needs and resources — to make the model more attractive for providers to participate.
- Outcomes-Based Approach: assessing provider performance with meaningful quality indicators, including offering a payment bonus to those providers who meet the indicators.
- Widespread Applicability: guaranteeing that the model can be easily adopted by a variety of practice types and is available to individuals from diverse communities.
To estimate the potential impact of this dementia care management model, Healthsperien developed an analytic model that compares federal spending under current law for Medicare beneficiaries with dementia to estimated expenditures under the proposed model over the next decade. The analysis found that those who receive dementia care management services will have fewer hospitalizations, fewer emergency department visits, improved medication adherence, and delayed entrance into nursing homes — all resulting in lower spending by the federal government. Specifically, Medicare savings would be $9.2 billion over 10 years, and federal Medicaid savings would total $11.7 billion — for a combined savings of $20.9 billion over the decade. In total over the 10 years, the federal government would see a 2.6:1 rate of return. That is, for every $100 the federal government spends providing dementia care management services on the front end, it would save $260 on the back end.
This coming Monday in Washington, D.C., The John A. Hartford Foundation in partnership with the Education Development Center is convening experts in dementia care and key federal agencies to explore how to provide better care to those living with dementia. At the convening, AIM will be presenting the new budgetary analysis and stressing the potential savings that could be achieved with dementia care management.
We’ve known that dementia care management is a proven way to improve the quality of care and quality of life for those living with Alzheimer’s and other dementias. Now we know that it would also save the federal government billions of dollars. As the experts convene on Monday, and as Congress continues to consider the Comprehensive Care for Alzheimer’s Act, these potential savings serve as further proof of the importance of including dementia care management in Medicare — and why the Center for Medicare & Medicaid Innovation (CMMI) should pilot a dementia care management model as AIM has proposed.