The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62818

David W. Coon, PhD¹, Elizabeth Edgerly, PhD², Katie Maslow, MSW³, Richard J. Moore, MD⁴, Susan Roth, RN, MS¹, Marilyn P. Williams, RN, MS⁵, Catherine Steinbach, RN, MS⁵, and Glenna Dowling, RN, PhD¹. (1) Research Center, Institute on Aging, 3330 Geary Blvd., 2 East, San Francisco, CA, CA 94118, (415) 750-4180, dcoon@ioaging.org, (2) Alzheimer's Association, 2065 W. El Camino Real, Suite C, Mountain View, CA 94040, (3) Managed Care Initiatives, Alzheimer's Association, 1319 F St., NW, Suite 710, Washington, DC 20004, (4) CPMC/BTMG, 3838 California Street, Suite 416, San Francisco, CA 94118, (5) Kaiser Permanente San Francisco, Kaiser Hospital, Mezzanine Level, 2425 Geary Blvd., San Francisco, CA 94115

The challenges of Alzheimer’s disease (AD) impact millions of U.S. patients, their families, and their health care providers. Recent prevalence reports on AD suggest that 7% to 14% of Californians age 65 and older had AD in 2000. These percentages expand considerably when AD is combined with dementia from other causes (e.g., vascular dementia). Providers and family members alike continue to express concerns about the diagnostic and care process for dementia patients. The NCCCND is an exciting initiative bringing together managed care and community based agencies in unprecedented partnerships designed to improve care and outcomes for dementia patients and their family caregivers in managed care plans. The intervention is grounded in model components (identification of possible dementia, diagnostic assessment, care management, and family caregiver information and support) that are translated into protocols and pathways designed to create effective systems of care across the disease course. This presentation focuses on lessons learned in the delivery of the intervention with over 300 dementia patients and their family caregivers. It highlights variability in the initiative’s processes and outcomes by contrasting partnership development between the same community based agency (the Alzheimer’s Association) and two distinct managed care models (i.e., a staff model versus an independent physician association). Key lessons learned include staying flexible to survive changing healthcare environments, sizing up partner resources to determine how much to implement at any one time, identifying existing infrastructures and rallying a core group of champions before implementation; and, selling the benefits of initiative enrollment during provider education.

Learning Objectives:

• Describe key components of a comprehensive model of care for dementia patients and their family caregivers relevant to managed care systems interested in partnerships with community based organizations.
• Identify key challenges to consider in the development of community based and managed care partnerships designed to improve care for dementia patients and family caregivers.
• List key strategies to improve the development and sustainability of community based and managed care partnerships designed to improve dementia care in divergent managed care systems.

Keywords: Dementia, Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.