The Alzheimer’s Association and the Alzheimer’s Impact Movement (AIM), a separately incorporated advocacy affiliate, are leading the way to advance policies to improve access to quality health care services for individuals living with Alzheimer's and all other dementia. Policymakers must enact policies that provide better health and long-term coverage to ensure high-quality, cost-effective care for the millions of people who face this disease every day. Important progress has been made but the agenda ahead remains immense.

Making early detection possible

Researchers have developed blood tests that can detect Alzheimer’s before symptoms appear — but under current law, Medicare cannot cover any screening test for diseases that cause dementia. This legal barrier means fewer than 10% of people living with mild cognitive impairment ever receive a diagnosis, leaving most without access to today’s FDA-approved treatments at the moment they would benefit most.

The ASAP Act clears that roadblock. The bill doesn’t mandate coverage — it simply gives Medicare the authority to cover early screening through its existing evidence-based process. Early detection gives individuals and families more time to begin treatment, plan ahead and seek support when it matters most.

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Creating a path to better dementia care

Caring for an individual with Alzheimer’s or another dementia poses unique challenges. Thankfully, dementia care management can ease these challenges, improve quality of care and reduce costs. Unfortunately, dementia care management programs have not developed within the current Medicare fee-for-service system.

The Alzheimer’s Association and AIM worked closely with bipartisan congressional champions to address this issue. The bipartisan Comprehensive Care for Alzheimer's Act would ask the Center for Medicare and Medicaid Innovation (CMMI) to test a different payment structure for dementia care management. The Comprehensive Care for Alzheimer's Act has the potential to streamline today’s complicated health care maze for people living with dementia and their caregivers.

Recognizing the broad bipartisan congressional support for the bill and the dementia care planning model, on July 31, 2023 the Centers for Medicare & Medicaid Services (CMS) announced an initiative to improve the way dementia care is delivered for people living with Alzheimer’s disease and other dementia. This test initiative, the Guiding an Improved Dementia Experience (GUIDE) Model, will be run through the Center for Medicare & Medicaid Innovation (CMMI).

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Addressing Alzheimer’s as a public health crisis

Working with bipartisan congressional champions the Alzheimer's Association, through AIM, was instrumental in the development and passage of the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act (P.L. 115-406). The bill, signed into law in December 2018, is creating an Alzheimer's public health infrastructure across the country to implement effective Alzheimer's interventions, such as:

• Increasing early detection and diagnosis.
• Reducing risk.
• Supporting the needs of caregivers.

The BOLD Infrastructure for Alzheimer's Act is also increasing implementation of the The Healthy Brain Initiative: State and Local Road Map for Public Health, 2023-2027 nationwide by:

• Establishing Alzheimer's centers of excellence.
• Providing cooperative agreements to public health departments.
• Increasing data collection, analysis and timely reporting.

Strengthening Medicaid

Today, more than 1 in 4 seniors with Alzheimer's and other dementias is on Medicaid. In its later stages, those who have the disease require an extraordinarily high level of hands-on care, often for years. Medicaid is the only public program that covers these long-term nursing home stays. Medicaid also covers home and community-based services which are critical for people with dementia, particularly in the early and middle stages of the disease.

It is imperative that those living with this devastating disease have access to affordable, quality care. The Alzheimer’s Association and AIM are working to strengthen Medicaid and improve coverage for those living with Alzheimer’s and other dementias. While Medicaid spending constitutes one of the largest items in most state budgets — and most states continue to face severe fiscal constraints — state policymakers must ensure that critical benefits are preserved. Learn more.

Preparing the dementia workforce

As we enter a new era of Alzheimer's treatment, access to a timely and accurate diagnosis is more critical than ever. The initial diagnosis of Alzheimer's is most often made by primary care providers — yet most report they do not feel prepared to diagnose or deliver care for those living with dementia. Structured virtual training programs have shown they can address these knowledge gaps, improve health outcomes and extend reach to rural and medically underserved communities where primary care physicians are especially strained.

Federal action

The bipartisan Accelerating Access to Dementia & Alzheimer's Provider Training (AADAPT) Act would provide grants to primary care providers participating in structured Alzheimer's and dementia virtual education programs — equipping them to better diagnose the disease and deliver high-quality, person-centered care in community-based settings.

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State action

State governments also must act. The Alzheimer's Association is working with governors and state legislatures to implement policies that recruit and retain professionals in the health care and direct care workforces, and require competency-based dementia training for staff involved in the delivery of care for those living with dementia.