A study recently published in Health Affairs highlights the high costs of dementia care and the need for a more comprehensive model of care.

The authors of the study emphasize that disease management for cases of dementia is more encompassing than traditional disease management due to cognitive and behavioral symptoms. As a result, dementia care involves managing social and legal complications in addition to a significant impact on family finances.

The authors believe that the quality of dementia care could be improved and the costs reduced if families affected by dementia could enroll in a program that comprehensively addresses the needs of people with a diagnosis and their families. The study notes that care should be individualized based on the functional, physical, and behavioral needs of the person diagnosed and care partners.

The authors suggest the creation of a nationwide alternative payment model (APM) that compensates physicians to support a comprehensive care model, and make five key recommendations for properly developing an APM:

1. The payment model should cover comprehensive dementia care that meets quality outcomes measures.
   • The model should contain core elements of comprehensive care that previous research has shown contributes to reduced hospital visits and admissions to long term care facilities. Minimum standards of care and guidelines for certification should be established.
2. The payment model should address both beneficiary and caregiver needs.
   • Dementia care that actively engages with both the person diagnosed and their care partner can reduce unnecessary hospital visits and time spent in medical care facilities, the study finds. Standardized care partner education and support should be required for APM participants.
3. To be eligible, beneficiaries must have a diagnosis of dementia.
   • Beneficiaries that enroll in the program should be required to have a diagnosis of dementia, and the APM itself should have a standardized process to confirm a diagnosis.
4. Comprehensive dementia care programs should be widely available to Medicare beneficiaries, especially those living in rural and underserved communities who have traditionally had difficulty accessing health care systems.
   • Comprehensive care should be available to those at increased risk for dementia, with an emphasis on people that have historically received inequitable care, such as the Black and Latino communities. Small community and rural health centers should be incentivized to participate in the APM.
5. The payment model should be capitated based on the severity of symptoms and available resources.
   • The APM should have multiple ways to pay providers that recognize the different needs of people with a diagnosis at different stages of dementia progression. The different methods should be based on use and the severity and type of symptoms of the person diagnosed.

The economic burden of FTD is twice as acute as that of Alzheimer’s disease, according to a study funded by AFTD. Click here to learn more.

If you are having financial difficulties related to FTD care, AFTD may be able to help. AFTD offers Comstock Grants to help alleviate the financial burdens of FTD care. Click here to learn more.