AFA welcomes inclusion of cognitive impairment screening in healthcare reform proposal

Sep 18 2009

The Alzheimer's Foundation of America (AFA) today applauded Senate Finance Committee Chairman Max Baucus (D-MT) and Senator Tom Carper (D-DE), who spearheaded the provision, for including cognitive impairment screening for Medicare beneficiaries in Baucus' healthcare reform proposal, "America's Healthy Future Act of 2009."

AFA had pressed for cognitive screening in light of the escalating incidence of Alzheimer's disease among aging Americans and mounting evidence that early diagnosis of memory problems is critical to appropriate treatment, behavioral interventions and support services. Early detection of memory problems is one of AFA's major national initiatives, highlighted by its annual National Memory Screening Day held each November.

"We applaud and thank Senator Carper and Chairman Baucus for their leadership in recognizing the value of cognitive screening and its potential impact on quality of life for older Americans," said Eric J. Hall, AFA's president and CEO. "The inclusion of cognitive screenings in Medicare wellness visits will help initiate long overdue and vital discussions about brain health between consumers and healthcare professionals."

Richard E. Powers, M.D., chairman of AFA's Medical Advisory Board, said it is noteworthy that the provision for the cognitive screenings, as well as the overall comprehensive health assessment, is framed in the context of disease prevention.

"Being proactive about risk factors and about memory concerns is the only way to attack this public health crisis," he said. "This is a major step forward toward elevating this issue to the stature deserved by all Americans."

Baucus' healthcare proposal, released yesterday as a "Chairman's Mark," or recommendation by a committee chair, is scheduled for markup by the Senate Finance Committee on September 22.

The provision for cognitive screening is included in a section on promoting disease prevention and wellness that would give Medicare beneficiaries access to a comprehensive health risk assessment to identify chronic diseases, modifiable risk factors, and emergency or urgent health needs. As part of the annual wellness visit, the proposal states that "optional elements, if appropriate, could include a cognitive impairment screening and administration of or referral for appropriate Medicare-covered immunizations and screening tests, among others."

All enrolled beneficiaries would be eligible for the wellness visit once every year beginning in 2011, and no co-payment or deductible would apply. Within six months of completing the assessment, Medicare would pay for a visit to a primary care provider to create a personalized prevention plan.

In a report, "Memory Matters," released last December, AFA underscored the value of memory screenings, noting that current research supports screening as a "safe, cost-efficient intervention that can reassure the healthy individual, promote successful aging and, when indicated, direct individuals to appropriate clinical resources."

At the time, Hall said the report serves as a "wake up call" to the public and medical professionals, as well as to policymakers.

The proposed inclusion of cognitive screening in the Medicare wellness visit is unfolding as AFA gears up for its National Memory Screening Day on November 17, an annual event that offers free, confidential memory screenings in local communities. Qualified healthcare professionals are expected to administer the non-invasive screenings to tens of thousands of Americans as well as distribute educational materials to countless others at more than 2,000 sites in local communities nationwide.

AFA encourages individuals who are concerned about memory loss, are experiencing warning signs or have a family history of dementia, or want to see how their memory is now and for future comparisons to take advantage of the screenings, which are conducted face-to-face and consist of a series of questions and tasks. The results do not represent a diagnosis, but individuals with below-normal scores or who still have concerns are strongly encouraged to follow up for a full medical examination. For more information, visit www.nationalmemoryscreening.org.

In previous years, surveys of participants in National Memory Screening Day showed that the majority of individuals with memory concerns had not discussed the issue with their physicians despite recent visits.

According to the National Institute on Aging, as many as 4.5 million Americans have Alzheimer's disease, which causes loss of memory and other intellectual functions. With age the greatest known risk factor, the incidence of the disease doubles every five years between 65 and 95.

The Alzheimer's Foundation of America is a nonprofit organization based in New York City that focuses on providing optimal care to individuals with Alzheimer's disease and related illnesses, and their families, and unites 1,200 member organizations nationwide that provide hands-on programs. AFA's services include a toll-free hot line with counseling by licensed social workers, a free caregiver magazine, a National Memory Screening Day initiative and the AFA Quilt to Remember. For information, call 866-AFA-8484 or visit www.alzfdn.org.