53 payer executives on the biggest opportunities in Alzheimer's, dementia care

As the number of Americans with Alzheimer's disease or related dementias continues to grow, a survey of payer executives suggests the industry is moving too slow or not at all toward better managing cognitive decline among members.

More than 12 million Americans are estimated to have Alzheimer's disease or dementia by 2025, costing health plans more than $345 billion annually. By 2050, the yearly cost is projected to reach $1 trillion.

The survey was conducted in March by consulting group Sage Growth Partners for Together Senior Health, a digital therapeutics platform. The survey results were published in June and include responses from 53 health plan executives across the country.

Five key takeaways:

1. Sixty percent of respondents said managing members with multiple chronic conditions is the most difficult disease group to manage, compared to 27 percent saying cognitive decline is the most challenging disease group to manage.

2. Eighty-three percent of respondents said they want to offer formal cognitive decline care programs to members.

3. Twenty-five percent of commercial plans offer formal care management programs to members with dementia or Alzheimer's, compared to 32 percent of managed Medicaid plans, 42 percent of D-SNP plans and 66 percent of Medicare Advantage plans.

4. Respondents said the most cost effective options for managing cognitive disorders today are routine primary care (42 percent), memory loss programs (36 percent), companionship benefits (34 percent), telehealth (24 percent), and daily home visits (21 percent). Group therapy, specialty care providers, digital engagement tools, and pharmaceuticals were not widely considered cost effective.

5. Respondents agreed or strongly agreed that reducing social isolation (89 percent), improving balance and physical health (86 percent) and non-pharmaceutical treatments (69 percent) are strong strategies for cognitive care.


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