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State Medicaid Programs Bear High Cost of Alzheimer's
Toronto (April 18, 1999) -- Alzheimer's disease patients have substantially higher Medicaid costs than their peers, and such expenses account for over 10 percent of all state Medicaid spending on the elderly, according to a study of the Pennsylvania Medicaid program. The research was presented during the American Academy of Neurology's 51st Annual Meeting in Toronto, Canada, April 17 -- 24, 1999.
"Ninety-six percent of the cost difference between Medicaid recipients with Alzheimer's disease and those without Alzheimer's was in nursing home services," said Joseph Menzin, PhD, study author and president of Boston Health Economics, Inc., a company specializing in outcomes research. "Over the course of one year, recipients with Alzheimer's and other types of dementia spent 228 days in nursing homes, on average, versus 120 days for a comparison group without these conditions."
The researchers analyzed 1995 Medicaid enrollment and claims data for Pennsylvania Medicaid recipients age 50 or older. Among the 316,000 Medicaid recipients, nearly 27,000, or 8.4 percent, were diagnosed with Alzheimer's and related types of dementia. Average Medicaid payments were approximately $8,200 higher among persons with Alzheimer's than those without. Based on these estimates, the Pennsylvania Medicaid program is projected to spend as much as $220 million annually for Alzheimer's disease.
The cost estimate for a typical patient with Alzheimer's and other types of dementia in Pennsylvania is similar to that found in parallel analyses conducted in states such as California and Georgia. However, as the sizes of state Medicaid populations vary widely, the total impact for each program is likely to differ.
"Given the anticipated growth in the elderly population, state officials may have an interest in alternative medical interventions to improve the care of Alzheimer's patients in the community, be it via case management, caregiver support or new drug therapies," Menzin said. "These strategies may offer the potential to delay or prevent nursing home placements."
Menzin said the results may not be applicable for the private insurance industry, since long-term custodial care, the major financial burden of Alzheimer's, is not typically covered.
"It is important for people to recognize that long-term care for the elderly with chronic conditions such as Alzheimer's disease is expensive, and the burden often falls on families," said Menzin. "Furthermore, when family financial resources are exhausted, it is Medicaid rather than Medicare that bears the lion's share of public expenditures for nursing home services."
Alzheimer's affects about four million people in the United States and is estimated to cost $21 billion annually in health care and related services. Alzheimer's is a debilitating, life-altering disease that attacks the brain, causing progressive memory loss. Patients also suffer difficulties with vision, language skills, judgment, personal care skills and emotional control.
This study was supported by Pfizer Inc., Outcomes Research Group, in New York, NY.
The American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professionals, is dedicated to improving care for patients with neurological disorders through education and research.
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Editor's Note: Dr. Menzin will present the research at the American Academy of Neurology's 51st Annual Meeting in Toronto, Canada, during the Health Services and Outcomes Research Platform Session on Sunday, April 18, 1999, at 3:15 pm in Room 206AC of the Metro Toronto Convention Centre.
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