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 Report Finds Alzheimer’s May Possibly Bankrupt States, Medicaid If Precautions Aren’t Taken

States should save their pennies for Alzheimer’s care—Medicaid costs for this disease are projected to increase in most states by more than  40 percent by 2025, according to a recent report released by the Alzheimer’s Association.

Medicaid, funded by state and federal governments, supports individuals with Alzheimer’s disease and other dementias in numerous ways, from institutionalized settings, such as nursing care centers, to home- and community-based programs and services (HCBS), such as adult day programs, transportation, and respite care. Because of these diseases’ long durations, intense care needs, and high cost of long term care services, this funding source is crucial for patients. Seniors with Alzheimer’s and other dementias rely on Medicaid at a rate nearly three times greater than that of other seniors, says the association.
The report, “The Impact of Alzheimer’s Disease on Medicaid Costs: A Growing Burden for States,” found that Medicaid costs for individuals living with Alzheimer’s disease and other dementias will increase in all states and the District of Columbia from 2015 to 2025.
“Now is the time for states to start addressing this issue,” says Matthew Baumgart, senior director of public policy at the Alzheimer’s Association, who encouraged states to expand opportunities for Medicaid beneficiaries to receive HCBS. “Most states have some form of these programs, yet only a small number of people actually use it due to long waiting lists. If implemented, people would have the benefit of staying home longer and putting off the need for even more Medicaid dollars to help them.”
These findings piggyback on another recent report from the Annals of Internal Medicine. According to this study, the costs of caring for a person with Alzheimer’s in the last five years of life is $287,038—dwarfing related costs for persons with cancer ($173,383) or heart disease ($175,136). Of those amounts, Medicare paid almost the same for patients with each of those diseases—close to $100,000. Yet patients with dementia averaged more out-of-pocket expenses ($61,663), 81 percent higher than for patients without dementia ($34,068). Medicaid costs in the last five years of life for people with dementia were more than 700 percent higher than for people without dementia ($35,346 vs. $4,552), Baumgart says.
Further sobering statistics from the Alzheimer’s Association report include:
·         In 2015, Medicaid costs for seniors living with Alzheimer’s disease and other dementias will exceed $1 billion in 11 states (New York, California, Pennsylvania, Ohio, Texas, Florida, New Jersey, Massachusetts, Illinois, Michigan, and North Carolina). By 2025, 20 states will spend more than $1 billion in Medicaid for this population.
·         In 2025, 35 states will see increases in Alzheimer’s Medicaid costs of at least 40 percent from 2015, including 22 states with increases of at least 50 percent. The largest percentage increases will be in the West: Alaska (107.5 percent), Nevada (92.1 percent), Arizona (76.1 percent), New Mexico (69.9 percent), and Wyoming (67 percent).
“The substantial growth of Medicaid costs in the near term merits a comprehensive review of state preparedness to meet the immediate and future care needs of people affected by Alzheimer’s and other dementias,” says the report. To date, 41 states have developed and implemented state Alzheimer’s disease plans.
Jackie Oberst is Provider’s managing editor. Email her at joberst@providermagazine.com or follow the magazine on Twitter @ProviderMag or @ProviderMyers.
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