Mechanisms for Organizational Behavior Change to Address the Needs of People Living with Alzheimer's Disease and Related Dementias Proceedings of a Workshop (2022) / Chapter Skim
Currently Skimming:
2 Keynote Presentations
2 Keynote Presentations
Pages 7-18
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 7... ...
and the Alzheimer's Association redefined AD to recognize three distinct stages of disease, which may be distinguished by biomarkers (Alzheimer's Association, 2022)
|
From page 8... ...
. He noted that despite its high cost, there is substantial opportunity for improvement in the quality of paid ADRD care, citing a published analysis that employed the Assessing Care of Vulnerable Elders (ACOVE-3)
|
From page 9... ...
He suggested that the additional pragmatic testing could be a good opportunity for collaboration with the NIA Impact Collaboratory.4 Reuben highlighted several new models of comprehensive ADRD care. Many of these models focus on the patient–caregiver dyad and are either community based, such as the Benjamin Rose Institute Care Consultation 1 See https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/ reach-protocol (accessed August 30, 2022)
|
From page 10... ...
, they all employ what Reuben described as the essential pillars of comprehensive ADRD care: • Continuous monitoring and assessment • Ongoing care plans • Psychosocial interventions for both people living with ADRD and caregivers • Self-management • Treatment of related conditions • Coordination of care Most of the models have been shown to benefit both patients and caregivers, and while they cost money to administer, they also produce savings. Despite their effectiveness, these programs are not widely available.
|
From page 11... ...
2020. Recommendations to improve payment policies for comprehensive dementia care.
|
From page 12... ...
The patients in the second and third tier differ in their intensity of behavioral symptoms and hospital visits, but individuals in both tiers are likely to require a high- or low-intensity dementia care program, as well as neurological and psychiatric care. Patients in the fourth and fifth tiers typically have less intense behavioral symptoms and fewer hospital visits than those in the other three tiers and can rely on a less intensive and far less expensive dementia care program as well as caregiver education and monitoring.
|
From page 13... ...
She opined that to address inequity at the level of the Center for Medicare's everyday operations it is essential that supporting those individuals remains central to operational decisions that affect system oversight, quality metrics, and navigability. The Center for Medicare is developing specific policies to address disparities in health care and to support health care organizations as they address those disparities.
|
From page 14... ...
She also noted that in order to increase momentum for system change, social services, health care, other support services, foundations and government grant makers, resources from ACO learning communities, and funding streams within CMS itself all need to be in alignment. Seshamani emphasized the importance of research partnerships, noting the power of research tools to evaluate changes and reveal inequities that have emerged during the COVID-19 pandemic, such as the expansion of telehealth, the use of community health workers, and integration of public health into the traditional health care system.
|
From page 15... ...
These considerations include identifying the target patient population, clarifying how the change will affect patient well-being, the patient's family members and other caregivers, patient-reported outcomes, health care outcomes, health care utilization, and health care spending. Addressing Systemic Health Inequities Jennie Chin Hansen asked how CMS could address the significant effect of ADRD on Black people that are dually eligible for Medicare and Medicaid, noting that people in this group have historically faced barriers to economic stability and health care inequities.
|
From page 16... ...
She added that efforts should not overlook people she referred to as double caregivers, people that are employed as caregivers and also serve as caregivers at home. Barriers to Innovation in Dementia Care Sharon Inouye, Harvard Medical School and planning committee member, noted that effective models for ADRD care that reduce costs and improve quality of care exist and asked the speakers to address the major barriers to their implementation.
|
From page 17... ...
Hollmann opined that one of the greatest challenges related to providing people with ADRD care at home is paying for care provided by community-based organizations and paying for the long-term support services that are generally considered the obligation of the patient and their family but are often prohibitively expensive. Seshamani said that the Medicare and Medicaid coordination office is considering opportunities to improve care for dually eligible individuals.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.