Alzheimer’s Patient Care Manager Practices and Policies

As health systems continue to evolve toward more managed care models, care managers are playing an important role in ensuring that people with Alzheimer’s disease or related dementias (ADRD) receive appropriate, well-coordinated, and cost-effective care. Research has shown that effective care management and referral to services and supports for patients with ADRD and their informal caregivers can decrease unnecessary medical services utilization, delay institutionalization, and improve the quality of life of both patients with ADRD and their informal caregivers. However, care managers are often unprepared to meet the needs of this challenging population.

The goal of this project was to systematically review and analyze care manager policies and practices within health plans participating in CMS’s demonstration programs for dual-eligible Medicare/Medicaid beneficiaries in 11 states, in order to:

1. Describe the role and scope of practice of care managers in the dual-eligible demonstration projects;
2. Identify any ADRD-specific training requirements of care managers;
3. Examine best practices in care management of dual-eligible beneficiaries with ADRD and their caregivers; and
4. Describe any changes impacting people with ADRD or their caregivers at the health system level.

For more information, contact [email protected].