Alzheimer’s disease affects 5.3 million people in the United States, and it is the 7th leading cause of death. In Wisconsin alone, 110,000 people currently live with Alzheimer’s. Despite its prevalence, effective treatments and cures have yet to be found. Due to the lack of therapies, those diagnosed with the disease often require long-term care, and Alzheimer’s care is a significant cost for patients, the state, and the country.
While older Americans make up about 12 percent of the population, they account for 90 percent of nursing home residents. In 2010, Alzheimer’s costs reached $172 billion dollars. Additionally, there are an estimated 10.9 million unpaid caregivers in the US providing around 12.5 billion hours of care. This contribution was valued at almost $144 billion, $2.6 billion in Wisconsin alone.
Long-term care and other Alzheimer’s costs are paid by a variety of sources including Medicare and Medicaid. In 2004, Medicare costs per Alzheimer’s patient ($15,145) were almost three times higher than costs for other Medicare recipients of the same age ($5,272). That same year, 28 percent of Medicare recipients aged 65 or older also received Medicaid benefits. Medicaid payments per Alzheimer’s patient ($6,605) were more than nine times higher than payments for other elderly people of the same age ($718).
Although Medicare, Medicaid, and other funding sources provide support for much of Alzheimer’s care, patients and families still must pay high out-of-pocket costs. These costs include premiums, co-payments, and services that are not covered by other sources. In 2004, out-of-pockets costs for Medicare recipients with Alzheimer’s averaged $2,464. Average out-of-pocket costs for patients living in nursing homes or assisted living facilities were significantly higher at $16,689.
Another cost accrued by Alzheimer’s patients is hospice care. The average length of stay for hospice patients with a diagnosis of Alzheimer’s was 105 days in 2008. Total payments for hospice care from all sources totaled $2.8 billion in 2004 with per person payments averaging $976 (compared to $120 per person for patients without Alzheimer’s).
Because the costs of Alzheimer’s care is so high, and because the aging of the baby boomer generation is expected to greatly increase the number of Alzheimer’s patients, strategies for decreasing Alzheimer’s care costs is necessary. This decrease could be achieved by shortening the disease course through earlier detection of the disease and more effective treatments. With these improvements, treatments would slow cognitive decline, delay the age at which the disease appears, and increase the years that Alzheimer’s patients can remain at home.
In a 2009 paper, two Wisconsin researchers addressed this issue and calculated the potential cost savings if early detection and treatment of Alzheimer’s were possible. Using a statistical analysis, the authors found that early detection and effective treatment of a 70-year-old woman with mild cognitive impairment would lead to $5,000 in state savings and $10,000 in federal savings. When a program of caregiver support was added to early detection and treatment, the analysis yielded even higher savings. The authors stated that, by their calculations, the state savings were higher than the cost of implementing an early diagnosis program. Therefore, if the state paid all costs of implementing an early detection and caregiver intervention program not covered by federal funds, the state would still save approximately $10,000 per diagnosed patient.
Currently, there is little incentive for caregiver support. This paper concludes that the lack of support for family and friends is fiscally irresponsible. With the development of caregiver support programs, patients could remain out of nursing home care for a longer period of time, thus significantly decreasing long-term care costs.
The high costs of Alzheimer’s care will continue to rise as people live longer and baby boomers approach the age at which Alzheimer’s is diagnosed. In addition to the impact on Medicare and Medicaid spending, out-of-pocket costs put another stress on patients and caregivers. With the current economic climate across the country, cuts in support for Alzheimer’s care may become necessary.
However, many studies are now focusing on the ability to detect and treat Alzheimer’s early, before cognitive decline can be measured. Through earlier detection, more effective treatment, and additional support for caregivers, the costs of Alzheimer’s care for the state, the country, and families would decline. Such a program would also provide hope and reassurance to those affected by a disease currently surrounded by uncertainty.
Data for this post provided by the Alzheimer’s Association.