Empowering Value-Based Care Providers in the Battle Against Alzheimer's Disease: Improving Outcomes and Reducing Costs

By Lata Stavropoulos, MD, ACO Medical Director

Alzheimer’s disease, a progressive brain disorder that leads to cognitive decline, is the most common cause of dementia. Over six million people in the United States have Alzheimer’s disease and, with the aging population, it is expected that this number will rise to about 13 million by 2050. As a major public health concern and a cause for significant disability and death, the cost to the United States is estimated to be about $350 billion annually.

The exact cause of Alzheimer’s is unknown, but genetic and environmental factors increase the risk. There is currently no cure for Alzheimer’s, but healthy behaviors to reduce risk, early diagnosis, and treatment can improve the quality of life.  
‍

How can patients and providers improve brain health?
‍

For patients:

Cognitive decline and dementia involving complex processes and strategies for prevention are being heavily researched. Several areas of actions with promising risk-reduction effects have emerged with epidemiological evidence:

• Manage chronic conditions such as diabetes, hypertension and hyperlipidemia
• Get enough sleep and address underlying problems that contribute to poor sleep (e.g. excess caffeine, sleep apnea, use of electronics, etc.)
• Sensory impairments—address vision and hearing issues with hearing aids, cataract surgery, routine vision assessments, etc.
• Eat a healthy diet rich in whole grains, fruits and vegetables
• Avoid smoking
• Avoid excess alcohol
• Maintain a healthy weight
• Social engagement—stay connected with friends and family
• Make exercise a part of your regular routine, specifically aerobic training
• Stay mentally active and learn new things; read, listen to podcasts, play games that challenge your brain, etc.
• See your primary care provider regularly for preventive care and for Annual Wellness Visits
  

For Providers:

Primary Care providers play a critical role in brain health and are typically the initial point of contact for patients to address cognitive issues. Specifically, value-based care providers are more likely to screen for cognitive decline and have success with early detection. This is helpful to rule out reversible causes of cognitive decline quickly, implement non-pharmacological treatments that can slow the progression of dementia and, lastly, give more time to educate caregivers and help them prepare for the challenges of caretaking.

• Educate patients on healthy lifestyles with evidence suggesting that doing so helps preserve good brain health and slows the progression of dementia. This is best done during preventive visits such as the Annual Wellness Visit
• Screening tests to detect dementia: Mini-Mental State Examination, Montreal Cognitive Assessment, and Alzheimer's Disease Assessment Scale-Cognitive
• Neuropsychiatric Inventory
• Any clinician eligible to perform evaluation and management services can offer a cognitive assessment
• Cognitive assessments can occur in outpatient settings, private residences, care facilities, or via telehealth
• Annual Wellness Visits require checking cognitive impairment and are an excellent way to screen patients
• If cognitive impairment is detected, a detailed assessment and care plan can be performed (CPT code 99483). If this is performed on the same day as the Annual Wellness Visit, then add modifier -25 to the claim
• Provide resources to patients with dementia and their families by coordinating care and educating them about available resources  
  ‍

Value-based care providers with an increased focus on preventive services can lead to higher rates of early detection, better management of chronic conditions, and improved care coordination. Ultimately, this can improve outcomes for patients with dementia, strengthen resources for families, and reduce the cost of care. Providers, if you would like to learn more about how Vytalize Health’s value-based care solution can improve outcomes for your patients with Alzheimer's, contact us here.