Conference Presentation, Fireside Chat, Panel, Statement
Reducing the Cost and Risk of Dementia
Milken InstituteNora Super, Michael Belleville, Jennie Chin Hansen, Kevin Crain, Jeff Huber, Shari Ling, Sarah Locke, Ian Cramer, Orion, Alan Stevens, Jill Lesser
- Global dementia prevalence is projected to reach overwhelming levels, necessitating a healthcare shift from cure-focused models to risk reduction and prevention strategies.
- CMS has introduced specific payment opportunities and billing codes to compensate clinicians for time spent detecting cognitive impairment, while simultaneously seeking evidence to validate that screening improves management and outcomes for the U.S. Preventive Task Force.
- The ET3 (Emergency Triage, Treat, and Transport) demonstration is expected to improve patient outcomes for older adults with multiple medical conditions by providing alternatives to emergency department transport, with the San Francisco regional initiative aiming to resolve emergency room diversion through community-wide hospital coordination.
- The number of accredited geriatric emergency departments is forecast to grow rapidly from eight to 105 within 18 months, with early data indicating reduced costs and fewer falls for discharged patients, while approximately 90% of these facilities currently operate without major funding.
- The financial services sector anticipates a pivot toward managing clients based on life stages and longevity expertise rather than asset size, driven by an average client age of 65 at major firms like Merrill Lynch and Bank of America's 2,000 longevity-accredited advisors.
- Home Instead projects delivering over 80 million hours of care this year, with the majority dementia-related, aiming to reduce healthcare system utilization including doctor visits, emergency room visits, and readmission rates.
- Early baseline cognitive testing for individuals in their 30s or 40s is proposed as a standard healthcare plan component to facilitate early medication intervention and establish baselines before home-based recognition occurs.
- Current dementia diagnosis rates are criticized for occurring at a stage comparable to stage four cancer, creating an urgent need to shift population identification methods to accommodate early-intervention requirements for upcoming pharmaceutical treatments.
- New financial service models require deeper understanding of family dynamics and data responsibilities to anticipate patterns like unusual withdrawals, while also incorporating psychological training for advisors managing spouses.
- Jeff Huber plans to launch a "Champions of Aging" pilot program designed to scale into a full-time paid year of service for post-college or gap-year individuals, intending to elevate this concept in presidential campaigns and expand the "I'm Ready to Care" text message community activation initiative.
- Quality measurement systems are expected to incentivize clinicians to detect and better manage cognitive impairment, though variability in annual wellness visit uptake across the country suggests coordinated care systems will achieve higher adoption rates.
- Employers are encouraged to allow staff to use volunteer hours for research participation, and caregiving firms intend to facilitate research studies by professionalizing caregivers and implementing data collection tools.
- Future healthcare models must address barriers to benefit usage through direct feedback from stakeholders and build alternative payment models around outcomes meaningful to individual trajectories, moving beyond metrics like hospitalization avoidance.