It’s been just about two weeks since the U.S. Supreme Court upheld the Affordable Care Act and policy pundits, healthcare providers, the media and the general public are deep into dissecting the decision and its ramifications for the future of our healthcare system.
One group cheering the court’s decision is the Alzheimer’s Foundation of America (AFA), which maintains that upholding of the healthcare act will result in earlier detection of Alzheimer’s disease—with care thereby starting sooner—while helping millions with more effective and efficient treatment.
The AFA claims it has been the main advocate for the inclusion of cognitive memory tests in the free Medicare annual wellness exams. (Prior to the ACA these tests have not been included in these no-charge annual assessments.) The AFA says the initiative will help address memory concerns, dementia and Alzheimer’s and reverse current under-diagnosis and misdiagnosis of these diseases. And, it points out that general practitioners currently miss about 50 percent of dementia cases, a staggering figure.
Eric J. Hall, president and CEO of the AFA, and a member of the Health and Human Services (HHS) Advisory Council that developed the National Alzheimer’s Plan, released in May, detailed the impact of the upholding of the ACA on people with Alzheimer’s and their caregivers in a phone interview with me yesterday.
In addition to the inclusion of the cognitive tests in wellness exams, Hall referenced pieces in the act that cover insurance and preexisting conditions, lifetime payment caps and closing the drug coverage donut hole. “These are issues that impact our people all the time,” Hall says. “We’re now waiting to see how the Medicaid issue plays out as a good number of our folks get care via Medicaid. Our membership has enormous needs and few fiscal resources that are shrinking.”
Hall also applauds the ACA’s promotion of geriatric training. “There’s an enormous gap in our geriatric workforce,” Hall says. “The other thing we’re excited about is that this [focus on training] connects directly with the National Alzheimer’s Plan.
“I doubt that any long-term care facility would deny the fact that their population has a growing percentage of cognitive issues, if not specifically Alzheimer’s,” Hall says. “We can’t deny the fact that it takes specific knowledge, education and experience to properly care for this population.”
Circling back to the issue of cognitive assessment, Hall makes a case for the tool to serve as a benchmark for future cognitive care in addition to ruling out other causes of memory loss. “Not all memory problems [indicate] that one has Alzheimer’s disease,” Hall says. “Simple things like thyroid [issues] or vitamin deficiency can be causes. Some prescription drugs can have a side effect of cognitive impairment. If some of these things are reversible aren’t they worth capturing?
“Also, if ultimately in the end there is a diagnosis of dementia there are some treatments available if we’re able to catch it early," Hall says. "Do we have a cure? No. But quality of life is all we’ve got and if the treatments are able to prolong a higher quality of life for a longer period of time than I think that is a goal.”