Alzheimer’s Association Launches Comprehensive Toolkit Following Medicare Decision To Cover Care Planning For People With Cognitive Impairment

April 19, 2017

WASHINGTON–Today, the Alzheimer’s Association announced the launch of the Cognitive Impairment Care Planning Toolkit for care providers. This comprehensive resource provides critical information and best practices for physicians, nurse practitioners, and physician assistants to better provide necessary care planning for individuals with cognitive impairment including Alzheimer’s and other dementias — which is now covered by Medicare.

Following a dementia diagnosis, care planning is crucial to improving outcomes and maintaining quality of life for the diagnosed and their caregivers, as well as controlling costs and planning appropriately for the future. The new G0505 Medicare code provides reimbursement for a clinical visit that results in a comprehensive care plan, allowing clinicians to develop a care plan and identify appropriate community support services that can contribute to a higher quality of life for those living with cognitive impairment.

The Cognitive Impairment Care Planning Toolkit was developed by the Alzheimer’s Association with input from other experts in the field. The toolkit, available at alz.org/careplanning, serves as a resource for clinicians to understand what the G0505 Medicare code covers, and to provide a wide variety of resources for the clinician to utilize in care planning sessions.

“For far too long, individuals were given a diagnosis and little else. We have worked with thousands of families who have had a better experience living through dementia because they had plans in place,” said Beth Kallmyer, Alzheimer’s Association Vice President of Constituent Services. “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.”

Through the release of the Toolkit, utilizing our wide chapter network, and engaging medical professionals, the Alzheimer’s Association is working to ensure that eligible care providers are aware not just of the new code, but also of the best way to conduct a proper evaluation and care planning session under the code. Materials in the toolkit include:
• Overview of the code;
• Easy access to validated tools to assist with diagnosis, such as the Mini-Cog™ and the Dementia Severity Rating Scale;
• Safety Assessment Guide;
• Caregiver Profile Checklist;
• End of Life Checklist; and
• Patient and Caregiver Resources.

The Alzheimer’s Association and its sister organization the Alzheimer’s Impact Movement (AIM) played a critical role in the decision by the Centers for Medicare & Medicaid Services (CMS) to pay for cognitive and functional assessments and care planning for patients with Alzheimer’s disease and other cognitive impairments. The decision, was supported by the Alzheimer’s Association and came following rapidly growing bipartisan support in Congress for the Health Outcomes, Planning, and Education (HOPE) for Alzheimer’s Act (S. 857, H.R. 1559), legislation conceived by the Alzheimer’s Association. And, to ensure the success of the new code, the Alzheimer’s Association Expert Task Force provided information and suggestions on its content and use to CMS. The Alzheimer’s Association Expert Task Force, comprised of a diverse group of experts from across the country that are currently providing care for individuals with Alzheimer’s and other dementias, also provided input on the Toolkit.

Today, an estimated 5.5 million Americans are living with the disease, and that number could rise as high as 16 million by 2050. What’s more, over 85 percent of people with Alzheimer’s and other dementias have one or more other chronic conditions, such as diabetes or heart disease. Care planning is critical for coordinating care and managing chronic conditions.