The year 2020 saw total payments for all individuals with dementia diseases reach an estimated 305 billion dollars. This substantial sum does not include the value of informal caregivers who are uncompensated for their efforts. Of this 305 billion dollars Medicare and Medicaid are projected to cover 67 percent of the total health care and long-term care costs of people living with dementia, which accounts for about 206 billion dollars of the total cost of care. Out-of-pocket expenditure projections are 22 percent of total payments or 66 billion dollars. Other payment sources such as private insurance, other managed care organizations, as well as uncompensated care account for 11 percent of total costs or 33 billion dollars.

The Centers for Medicare and Medicaid (CMS) cite that 27 percent of older Americans with Alzheimer’s or other dementias who have Medicare also have Medicaid coverage. In comparison, the percentage of those Americans without dementia is 11 percent. The addition of Medicaid becomes a necessity for some as it covers nursing homes and other long-term care services for those individuals with meager income and assets. The extensive use of CMS services, particularly Medicaid, by people with dementia translates into extremely high costs. Despite the high rate of expenditure by federal social and health services, Americans living with Alzheimer’s and other forms of dementia still incur high out-of-pocket expenses compared to beneficiaries without dementia. Much of these costs pay for Medicare, additional health insurance premiums, and associated deductibles.

alz.org

Older Americans living with Alzheimer’s or other forms of dementia have twice the number of hospital stays per year than those without cognitive issues. Dementia patients with comorbidities such as coronary artery disease, COPD, stroke, or cancer, to name a few, have higher health care costs than those without coexisting serious medical conditions. In addition to more hospital stays, older Alzheimer’s sufferers require more home health care visits and skilled nursing facility stays per year than other older people without dementia.

Cost projections for Medicare, Medicaid, and out-of-pocket costs for Americans living with Alzheimer’s disease or other forms of dementia continue to increase. The average life span of an American with Alzheimer’s is 6 -8 years, and as the disease progresses, so do the requirements of care and support. This care and support include medical treatment, prescription medications, medical equipment, safety services, home safety modifications, personal care, adult daycare, and ultimately residence in a skilled nursing facility. Disease-modifying therapies and treatments remain elusive, and there is no cure for Alzheimer’s and other dementia diseases. ADRD imposes a tremendous financial burden on patients and their families, payers, health care delivery systems, and society.

In the absence of a cure, the Alzheimer’s Association predicts the total direct medical cost expenditures in the US for ADRD will exceed 1 trillion dollars in 2050 because of increases in elderly population projections. Health policy planners and decision-makers must gain a comprehensive understanding of the economic gravity that Alzheimer’s and other dementia diseases present to the US population. The direct and indirect total medical and social costs and accompanying solution-driven mandates must be identified to CMS, private insurance groups, facilities with dementia units, and family systems that function as non-compensated caregivers.

We help families plan for the possibility of needing long-term care, and how to pay for it. If you or a loved one would like to talk about your needs, we would be happy to help. Contact our office at (740) 947-7277 and schedule a free consultation to discuss your legal matters.

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New Insights on The Alzheimer’s Disease Research

The developments for both conditions center around relatively new insights into brain function. It seems that brain cells require a certain fluidity or agility to move between two rates of neuronal firing. Any further explanation plunges into the deep weeds of physics and neurology, but a recent interview on National Public Radio with researchers likened the healthy process as similar to the fluidity with which water changes from vapor to dewdrop to ice. In the case of the two illnesses, it seems that brain cells that should act with comparable fluency turn “sticky” instead. Dr. J. Paul Taylor, a neurogeneticist at St. Jude Children’s Research Hospital in Memphis and with the Howard Hughes Medical Institute, likened the disease process to what happens when honey is left in the refrigerator. Dr. Taylor won the 2020 Potamkin Prize for Alzheimer’s research.

Also quoted in the NPR interview was biophysical engineer Cliff Brangwynne, of Princeton and also with the Howard Hughes Medical Institute. He likened a healthy brain cell to acting like people coming and going at a party, chatting with each other, but the cells in ill brains have lost that ability to communicate fluidly.

Millions stand to benefit. According to the Alzheimer’s Association, one in three seniors dies from Alzheimer’s or other dementia. More than 16 million Americans provide unpaid care for such people. Between 2000 and 2018, deaths from heart disease have decreased by 7.8% while deaths from Alzheimer’s have increased by 146%.

New Insights on ALS Research

As for ALS, Johns Hopkins estimates that the illness affects as many as 30,000 in the United States, with 5,000 new cases diagnosed each year. Estimates suggest that ALS is responsible for as many as five of every 100,000 deaths in people aged twenty or older, most commonly in people over age sixty. The disease process causes terrible suffering.

Pharmaceutical company Bayer and Dewpoint Therapeutics are partnering to produce treatments using this new technology for dementia, ALS, and other cancer conditions as well.

Diseases like Alzheimer’s and ALS can cause not only emotional stress for families but financial stress as well. We help families deal with legal and financial issues related to caring for a loved one with a serious disease. Contact our office at (740) 947-7277 and schedule a free consultation to discuss your legal matters.

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