Care coordinators play an increasingly important role in ensuring that people with Alzheimer’s disease or related dementias (ADRD) receive appropriate, well-coordinated, and cost-effective care. Yet, care coordinators are often unprepared to meet the needs of this challenging population
In Dementia Care Coordination Workforce and Practices in Seven Duals Demonstration States, UCSF Health Workforce Research Center authors Brooke Hollister, PhD and Susan Chapman, RN PhD FAAN, systematically reviewed and analyzed care coordinator policies and practices within health plans participating in the US Centers for Medicare & Medicaid Services’ (CMS) demonstration programs for dually-eligible Medicare and Medicaid beneficiaries (referred to as “duals”). The research was designed to enhance knowledge of the care coordination workforce and practice requirements in duals demonstrations. The report focuses on 7 states, and examines the governing 3-way contracts between CMS, the states, and health plans or other contracted entities, as well as interviews with 24 key informants selected for their expertise in the care coordination workforce, dementia care coordination, or duals demonstration policy.
Among the authors’ key findings are that experience and training requirements for care coordinators were often broadly defined. With some exceptions, there was little specificity as to the training content or required competencies for ADRD care coordinators. Requirements and practices as defined in duals demonstrations appeared to turn on several factors: 1) workforce availability and qualifications; 2) existing state policies concerning Medicaid waivers, Medicare Advantage Programs, and Managed Long-Term Services and Supports; and 3) the stakeholder process and strength of advocacy movements surrounding the creation of the duals demonstrations in the particular state.
The authors highlight the need for a workforce of adequate numbers of dementia-capable care coordinators to serve people with ADRD and their caregivers. They conclude that promising practices for the utilization of existing workforce resources and dementia-capable training for care coordinators exist, however all demonstrations will benefit from evaluation of outcomes resulting from policies impacting people with ADRD and their caregivers.