[PPT] - Alzheimers Disease and Related Dementias: A Payers Perspective PowerPoint Presentation

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Alzheimer’s Disease and Related Dementias: A Payer’s Perspective

Martha Roherty September 8, 2017

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1. Ensuring Compliance with the Medicaid Home and Community-based Services Regulation 2. Adult Protective Services and Elder Justice 3. Improving Quality Across Programs

4. Managed Long-Term Services and Supports

5. Implementing the Long-term Care Ombudsman Regulation

6. Addressing Senior Hunger, Nutrition, and Food

Insecurity 7. Services for Individuals with Alzheimer’s and Related Dementia

2017 Top Priorities for Aging &Disability Agency Leadership

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Medicare—inpatient hospital care; some doctor’s fees;

some medical items; outpatient drugs; some home health under certain conditions but does NOT pay for person to assist with daily activities or long term nursing home care

Medicaid—is based on both functional and financial

eligibility and varies state by state. If eligible, Medicaid will pay for nursing home care and if qualitied under HCBS waiver program—pay for services in home and community settings.

Older Americans Act—everyone 60 and over is eligible

but because of limited funding must meet targets.

Federal Programs Supporting Alzheimer’s Care

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Average Cost of Care

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Average Cost of Care

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Average Cost of Care

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Adult Day Health/Adult Day

Services

Dementia Support Groups
Case Management
Congregate/Home Delivered

Meals

Family Caregiver Support
Homemaker
Independent Living
Legal Assistance
LIHEAP
Personal Care
Senior Centers
Respite
Information &

Referral/Options Counseling

Examples of OAA Funded Services for Individuals with Dementia

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Current OAA Clients & Potential Eligibles

20,000,000 40,000,000 60,000,000 80,000,000 100,000,000 120,000,000 140,000,000 2010 2011 2012 2013 2014 2015

Number of Persons 60 and Above Age 60 and above & Below 250% FPL Age 60 and above & Below 200% FPL Number of Persons Receiving OAA Services

Number of Persons Year

Source: NASUAD Analysis of U.S. Census (Current Population Survey) and AGID Data

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Change in Medicaid HCBS Expenditures FY15-FY16 (for specific populations)

5 10 15 20 25 30 35 Alzheimer's disease and related dementias Adults with Autism Spectrum Disorder Adults with ID/DD Older Adults (age 65+) Adults with Physical Disabilities Adults with Behavioral Health Conditions Individuals with Traumatic or Acquired Brain Injuries Children with ID/DD

Number of States Stayed the Same Decreased Increased

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Change in Medicaid HCBS Caseload FY15-FY16 (for specific populations)

5 10 15 20 25 30 35 Alzheimer's disease and related dementias Adults with Autism Spectrum Disorder Adults with ID/DD Older Adults (age 65+) Adults with Physical Disabilities Adults with Behavioral Health Conditions Individuals with Traumatic or Acquired Brain Injuries Older individuals with ID/DD (age 65+) Children with ID/DD

Number of States Stayed the Same Decreased Increased

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Adult Day Centers Provide Medical Services

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Residential Settings that May not Meet Requirements

2 4 6 8 10 12 14 16 18 20

Number of States

Residential Settings that May not Meet Requirements

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Importance of Caregiving

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The Growing Value of Caregiving

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Profile of Caregivers in America

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Or call us at: 202-898-2578

For more information, please visit: www.nasuad.org

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