Charting a Course to Improve Care Across America

 For more than a decade, the National Alzheimer’s Project Act (NAPA) has served as our nation’s roadmap for confronting Alzheimer’s disease. Last week, as Chair of the NAPA Advisory Council, I had the privilege of helping finalize the recommendations that will shape the next chapter of that effort.

These recommendations come at a pivotal moment in Alzheimer’s care, as unprecedented advances in diagnosis, treatment, and prevention are reshaping what is possible for patients and families. Blood-based biomarker tests can detect Alzheimer’s pathology with a simple blood draw. Research continues to strengthen the evidence that lifestyle interventions can help reduce risk and slow cognitive decline. Disease-modifying therapies can now slow progression for some patients in the earliest stages of disease.

Our challenge is ensuring that public policy keeps pace with scientific progress so patients and families can benefit from these breakthroughs.

Rather than simply identifying problems, our recommendations provide an actionable roadmap for the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), the Food and Drug Administration (FDA), and Congress to modernize Alzheimer’s prevention, diagnosis, treatment, and care.

Our recommendations call on policymakers to:

Make early detection the national standard.

Alzheimer’s should no longer be diagnosed only after families reach a crisis point. We recommend that HHS direct CMS to standardize validated cognitive assessments during the Welcome to Medicare Visit and Medicare Annual Wellness Visit, giving every older American the same evidence-based opportunity for early detection and earlier intervention. As I outlined in my recent Washington Examiner op-ed, standardized cognitive assessment should become a routine part of preventive healthcare.

We also recommend that Congress pass the bipartisan Alzheimer’s Screening and Prevention (ASAP) Act and Concentrating on High-Value Alzheimer’s Needs to Get to an End (CHANGE) Act so Medicare can keep pace with scientific advances by expanding access to emerging blood-based screening technologies and evidence-based cognitive assessment tools.

Help Americans protect their brain health before symptoms begin.

Alzheimer’s disease begins years or even decades before memory loss becomes obvious. Our recommendations call for a coordinated national brain health campaign that educates Americans about risk reduction, healthy lifestyle interventions, baseline cognitive assessments, and why early diagnosis matters now that meaningful treatments, support services, and clinical trials are available.

Equip clinicians to diagnose and care for patients earlier.

Earlier diagnosis only improves lives if healthcare providers have the knowledge, training, and tools to act. We recommend that CMS educate clinicians on existing Medicare billing codes for cognitive assessment and dementia care, strengthen care pathways from screening through treatment, and expand workforce training so providers can diagnose patients with confidence and connect them to timely care and support.

Accelerate innovation and expand access.

Scientific breakthroughs should not spend years waiting to reach patients. We recommend that HHS coordinate efforts across the Food and Drug Administration, the Centers for Medicare & Medicaid Services, and other federal agencies to accelerate promising diagnostics and therapies while strengthening care navigation, expanding access to clinical trials, and ensuring patients can benefit from every scientific advance as quickly and equitably as possible.

Every generation hopes to leave the next one better off. These recommendations support a healthcare system that ensures patients, families, and caregivers have pathways to detect Alzheimer’s earlier and treat it more effectively to stay healthy and independent longer.

The future of Alzheimer’s care is being written today; these recommendations ensure patients and families are at the center of every chapter.

Michelle Branham is secretary of the Florida Department of Elder Affairs, former vice president of public policy in Florida for the Alzheimer’s Association, and current chairwoman of the Advisory Council on Alzheimer’s Research, Care, and Services for the U.S. Department of Health and Human Services.

https://solvingalzheimers.substack.com/p/charting-a-course-to-improve-care-across-america