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Redesigning Health Care for Dementia: From Wish Through Policy to Practice
2013 AAGP Annual Meeting Magruder, MPH, PhD will be the Discussant for the symposium. She will discuss the papers in the context of new epidemiologic findings concerning the course and consequences of PTSD in older adults. Faculty Disclosures: John Kasckow, MD, PhD Other: Health Hero - Health Hero waived some of the fees on some of the expenses related to using their telehealth system for the research study. Kathryn M. Magruder, PhD Nothing to disclose Steven R. Thorp, PhD Nothing to disclose Matthew Yoder, PhD Nothing to disclose
REDESIGNING HEALTH CARE FOR DEMENTIA: FROM WISH THROUGH POLICY TO PRACTICE Soo Borson, MD1,2; Rebecca G. Logsdon, PhD2; Tatiana Sadak, ARNP, PhD2; Joshua Chodosh, MD, MSHS3 1
University of Washington Department of Psychiatry and Behavioral Sciences, Seattle, WA University of Washington Department of Psychosocial and Community Nursing, Seattle, WA 3 University of California at Los Angeles, Los Angeles, CA 2
Abstract: A large cumulative body of literature supports the need for improvements in health care for patients with dementia. Underdiagnosis in primary care, and the reasons for it, have been well known for many years, yet anticipation of predictable dementia-related complications, such as adverse consequences of medication mismanagement, late presentation of treatable medical and neuropsychiatric problems requiring costly crisis management, and caregiver exhaustion and medical decompensation, have historically not been embraced as specific targets for health care planning and delivery. Two new pieces of federal legislation, if effectively implemented, should dramatically improve this situation over the next decade. First, the Annual Wellness Visit, a new Medicare benefit launched in January 2011, calls for objective cognitive evaluation and an overall assessment of health risks. Together, these two assessments, conducted in a specially scheduled non-acute health care planning visit, are meant to help clinicians organize and provide anticipatory, evidence based care. Second, the National Alzheimer’s Project Act (NAPA) called for convening multidisciplinary implementation workgroups to articulate and press for new national commitments in three areas: increased discovery research funding, development of models for providing comprehensive health care for persons with dementia and quality measures for assessing it, and much greater investment in family caregiving research and support. Detailed workgroup recommendations for NAPA implementation were submitted for federal review by NIH and CMS published online in spring 2012. At the same time, the AMA endorsed a new set of quality measures for assessing dementia management in healthcare settings and special CMS codes to be used in health system audits. Speakers will present tools to help clinicians provide high-quality, comprehensive health care to patients, results of outcomes research demonstrating clinically-relevant benefits of patient and caregiver participation in early-stage support groups, development of a new measure of family caregiver activation to strengthen partnerships between family caregivers and providers, and systems initiatives that encourage and support improvements in care. Faculty Disclosures: Soo Borson, MD Nothing to disclose Joshua Chodosh, MD, MSHS Nothing to disclose Rebecca G. Logsdon, PhD Nothing to disclose Tatiana Sadak, ARNP, PhD Nothing to disclose
S30
Am J Geriatr Psychiatry 21:3, Supplement 1
REDESIGNING HEALTH CARE FOR DEMENTIA: FROM WISH THROUGH POLICY TO PRACTICE Soo Borson, MD1,2; Rebecca G. Logsdon, PhD2; Tatiana Sadak, ARNP, PhD2; Joshua Chodosh, MD, MSHS3 1
University of Washington Department of Psychiatry and Behavioral Sciences, Seattle, WA University of Washington Department of Psychosocial and Community Nursing, Seattle, WA 3 University of California at Los Angeles, Los Angeles, CA 2
Abstract: A large cumulative body of literature supports the need for improvements in health care for patients with dementia. Underdiagnosis in primary care, and the reasons for it, have been well known for many years, yet anticipation of predictable dementia-related complications, such as adverse consequences of medication mismanagement, late presentation of treatable medical and neuropsychiatric problems requiring costly crisis management, and caregiver exhaustion and medical decompensation, have historically not been embraced as specific targets for health care planning and delivery. Two new pieces of federal legislation, if effectively implemented, should dramatically improve this situation over the next decade. First, the Annual Wellness Visit, a new Medicare benefit launched in January 2011, calls for objective cognitive evaluation and an overall assessment of health risks. Together, these two assessments, conducted in a specially scheduled non-acute health care planning visit, are meant to help clinicians organize and provide anticipatory, evidence based care. Second, the National Alzheimer’s Project Act (NAPA) called for convening multidisciplinary implementation workgroups to articulate and press for new national commitments in three areas: increased discovery research funding, development of models for providing comprehensive health care for persons with dementia and quality measures for assessing it, and much greater investment in family caregiving research and support. Detailed workgroup recommendations for NAPA implementation were submitted for federal review by NIH and CMS published online in spring 2012. At the same time, the AMA endorsed a new set of quality measures for assessing dementia management in healthcare settings and special CMS codes to be used in health system audits. Speakers will present tools to help clinicians provide high-quality, comprehensive health care to patients, results of outcomes research demonstrating clinically-relevant benefits of patient and caregiver participation in early-stage support groups, development of a new measure of family caregiver activation to strengthen partnerships between family caregivers and providers, and systems initiatives that encourage and support improvements in care. Faculty Disclosures: Soo Borson, MD Nothing to disclose Joshua Chodosh, MD, MSHS Nothing to disclose Rebecca G. Logsdon, PhD Nothing to disclose Tatiana Sadak, ARNP, PhD Nothing to disclose
S30
Am J Geriatr Psychiatry 21:3, Supplement 1