Innovation in care for individuals with cognitive impairment: Can reimbursement policy spread best practices?

Soo Borson; Joshua Chodosh; Cyndy Cordell; Beth Kallmyer; Malaz Boustani; Anna Chodos; Jatin K Dave; Lisa Gwyther; Susan Reed; David B Reuben; Stephen Stabile; Monica Willis-Parker; William Thies

doi:10.1016/j.jalz.2017.09.001

Innovation in care for individuals with cognitive impairment: Can reimbursement policy spread best practices?

Alzheimers Dement. 2017 Oct;13(10):1168-1173. doi: 10.1016/j.jalz.2017.09.001. Epub 2017 Sep 18.

Authors

Soo Borson¹, Joshua Chodosh², Cyndy Cordell³, Beth Kallmyer⁴, Malaz Boustani⁵, Anna Chodos⁶, Jatin K Dave⁷, Lisa Gwyther⁸, Susan Reed⁹, David B Reuben¹⁰, Stephen Stabile¹¹, Monica Willis-Parker¹², William Thies¹³

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Department of Neurology, University of Minnesota, Minneapolis, MN, USA. Electronic address: soob@uw.edu.
² Division of Geriatric Medicine and Palliative Care, School of Medicine, New York University, New York, NY, USA.
³ Division of Constituent Services, Alzheimer's Association, Chicago, IL, USA.
⁴ Division of Care and Support, Alzheimer's Association, Chicago, IL, USA.
⁵ Indiana University Center for Health Innovation and Implementation Science, Sandra Eskenazi Center for Brain Care Innovation, Indianapolis, IN, USA.
⁶ Division of Geriatrics, University of California San Francisco, San Francisco, CA, USA.
⁷ New England Quality Care Alliance, Division of Palliative Care, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
⁸ Department of Psychiatry and Behavioral Sciences, Duke University Center for Aging, Durham, NC, USA.
⁹ Kelsey-Seybold Clinic, Houston, TX, USA.
¹⁰ Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.
¹¹ PrimeCare Community Health, Inc., Chicago, IL, USA.
¹² Department of Neurology, Emory University, Atlanta, GA, USA.
¹³ Division of Medical and Scientific Affairs, Alzheimer's Association, Chicago, IL, USA.

PMID: 28926722
DOI: 10.1016/j.jalz.2017.09.001

Abstract

There is now an unprecedented opportunity to improve the care of the over 5 million people who are living with Alzheimer's disease and related dementias and many more with cognitive impairment due to brain injury, systemic diseases, and other causes. The introduction of a new Medicare care planning benefit-long sought openly by advocacy organizations and clinicians and badly needed by patients and families-could greatly improve health care quality, but only if widely and fully implemented. We describe the components of this new benefit and its promise of better clinical care, as well as its potential to create a new platform for clinical and health outcomes research. We highlight external factors-and some that are internal to the benefit structure itself-that challenge the full realization of its value, and we call for broad public and professional engagement to ensure that it will not fail.

Keywords: Barriers; Care planning dementia; Implementation; Practice tools; Primary care.

MeSH terms

Cognitive Dysfunction / diagnosis*
Cognitive Dysfunction / therapy*
Humans
Medicare*
Quality of Health Care*
Reimbursement Mechanisms* / legislation & jurisprudence
United States