After years of pressure from patient advocate groups, a recent change in Medicare law will now allow primary care doctors to be reimbursed for Alzheimer’s testing, resulting in quicker diagnoses for elderly patients. Prior to this new rule physicians did not regularly test for dementia and patients often went undiagnosed and untreated until their lives became unmanageable or a crisis occurred.
The testing for Alzheimer’s disease is a multi step process, including brain imaging, blood tests, comprehensive physical and neurological exams, and the patient’s full medical history. Now physicians can bill Medicare for all of these services.
But this is only the first step. Once a diagnosis is made, care planning is a critical next step for Alzheimer’s patients. According to Robert Egge, Alzheimer’s Association Chief Public Policy Officer, “Proper care planning results in fewer hospitalizations, fewer emergency room visits and better management of medication — all of which improves the quality of life for both patients and caregivers, and helps manage overall care costs.” Physicians are now able to bill for their services in providing the family and patient available treatment and programs.
This is a critical step forward for Alzheimer’s and dementia patients, especially because as many as 85% have other chronic conditions, according to the Alzheimer’s Association. The cost of caring for those with Alzheimer’s disease and other forms of dementia was estimated to total $236 billion dollars in 2016.
A diagnosis of Alzheimer’s affects the entire family. An early diagnosis of the disease, combined with access to care planning services leads to better outcomes for patients and their families.
The new law does not make any changes to the coverage provided by Medicare for residential living facilities. Some counties in California have their own programs and may be able to assist those in need, but Medicare continues to only cover skilled nursing needs.
Alzheimer’s and similar diseases can also present a host of legal complications for families. If estate planning documents such as the Advance Healthcare Directive and Power of Attorney have not been executed prior to the diagnosis, a Conservatorship may be necessary.
Planning ahead for legal and financial matters, and regular checkups or screenings are the best tools families have to manage Alzheimers.