Detecting Dementia: Emerging Innovations and Their Implications for American Adults and Their Health Care
October 16, 2024
Most American adults are not routinely screened or assessed for dementia until symptoms are apparent or readily recognizable. A wide array of innovations are now emerging that can enable dementia screening and assessment more rapidly, comprehensively, and at greater scale than typically seen today. Innovative tests, tools, and protocols are also creating capabilities to detect dementia at an early and even pre-symptomatic stage.
NEHI's Tom Hubbard discussed the innovations and their implications with leading experts in the field, including:
- Elli Kaplan, MBA, Cofounder & CEO of Neurotrack
- Vijaya Kolachalama, PhD, FAHA, Associate Professor, Boston University School of Medicine
- Jennifer Pollack, JD, Director of Access Policy, Alzheimer's Association and Alzheimer's Impact Movement
- Claire Sexton, DPhil, Senior Director of Scientific Programs & Outreach, Alzheimer's Association
Among the topics discussed were:
- The impact of new and emerging innovations in dementia screening and assessment--and in brain health assessment more broadly--in the primary care setting;
- The future use of blood-based biomarkers in dementia detection and diagnosis;
- The emerging capabilities of AI and predictive analytics to identify individuals at risk for dementia and related disorders; and
- Current and expected barriers to adoption and payer reimbursement for innovative dementia screening and assessment.
The Alzheimer's Disease Patient Journey: Pathways to Early-Stage Screening and Detection
May 23, 2024
In conjunction with our project to examine the earliest steps in the Alzheimer's disease patient journey, from screening and assessment for Mild Cognitive Impairment (MCI) and dementia to follow-up steps that may trigger referral to other services for diagnosis of Alzheimer's disease or other neurological disorders, NEHI convened an expert roundtable in Washington on May 23, 2024. Moderated by NEHI's Tom Hubbard and Lauren Bedel, the roundtable featured two panels that explored the wide range of innovative tests and tools now emerging for dementia assessment and the implications they pose for primary care and dementia-related services.
The first panel focused on the array of innovations now emerging or in development, including digital screening tools capable of detecting multiple signs of Mild Cognitive Impairment and dementia, to tests of biomarkers found in blood and skin. These innovations could enable primary care physicians and other frontline practitioners to identify dementia in patients at a greater scale, more quickly and accurately. However, NEHI's second panel pointed out the considerable barriers that must be overcome to take full advantage of new tests and tools. They include limited access to–-and increasing shortages in–-primary care teams and neurologists. There is also limited payment support for greater uptake of dementia screening and assessment and longstanding stigmas associated with dementia and Alzheimer’s disease continue to deter action. Panelists urged continued efforts to destigmatize dementia and point patients, families, and clinicians toward greater attention to the multiple factors associated with dementia. These factors not only include progression to Alzheimer’s disease but also complications of heart disease, stress, polypharmacy, and other preventable or treatable issues.
Panelists:
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Deborah E. Barnes, PhD, MPH, Professor, Departments of Psychiatry and Behavioral Sciences and Epidemiology & Biostatistics, UCSF Weill Institute for Neurosciences and Osher Center for Integrative Health, University of California, San Francisco
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David Bates, PhD, CEO & Co-Founder, Linus Health
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James Hendrix, PhD, Executive Director for US Medical Affairs, Eli Lilly & Company
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Todd Levine, MD, Chief Medical Officer & Co-Founder, CND Life Sciences; Clinical Neurologist
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Josh Soldo, Chief Scientific Officer & Co-Founder, Veravas, Inc.
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Amanda Bartelme, Executive Director, Policy, Eisai, Inc.
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Angela Hsu, MD, Physician Director of Memory Care Services, Mid-Atlantic Permanente Medical Group
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Ian Kremer, JD, Executive Director, LEAD (Leaders Engaged on Alzheimer’s Disease) Coalition
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Scott Sarran, MD, MBA, Chief Medical Officer, Harmonic Health
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Karen Tracy, Vice President of Strategic Alliances & Integrated Communications, Gerontological Society of America
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Julie Wood, MD, MPH, FAAFP, Senior Vice President of Science and Clinical Strategy, American Academy of Family Physicians; Family Physician
Understanding Innovation in Screening and Diagnosis of Alzheimer's Disease and Related Dementias
April 11, 2024
The recent approval of new drug therapies not only signals a new era in treatment of Alzheimer’s disease but also underscores the urgent need for innovations that will enable early screening for Mild Cognitive Impairment and accurate detection of all forms of dementia, including complex manifestations of Alzheimer’s disease.
Innovations currently in development or now emerging in the marketplace include a wide variety of tests and tools for cognitive and functional assessment and for biomarkers of disease found within the brain. These innovations may enable health care providers to assess patients more accurately and at a greater scale at a time when both primary care providers and neurologists are under great stress throughout the U.S. health care system.
NEHI's Tom Hubbard and Lauren Bedel hosted a webinar to explore these innovations with the following experts:- David Bates, Ph.D., CEO, Linus Health
- Joel Braunstein, MD, CEO, C2N Diagnostics
- Ian Kremer, JD, Executive Director, LEAD (Leaders Engaged on Alzheimer's Disease) Coalition
The Current State of and Emerging Trends in Clinical Training for Telemental Health
December 11, 2023
The delivery of behavioral and mental health services via synchronous or asynchronous technology, i.e. telemental health (TMH), has increased rapidly in recent years. NEHI's Claire Cruse presented the findings from our work in this area and moderated a discussion with experts from payers, providers, health technology, and major academic organizations on how to ensure TMH clinicians are trained on evidence-based practices that have been shown to produce high-quality patient outcomes.
Addressing Persistent Disparities in Colorectal Cancer Screening Among Racially and Ethnically Diverse Populations
October 17, 2023
On October 17, 2023, NEHI convened experts from across the health care ecosystem for an in-depth discussion related to the findings of our recent report, “Addressing Persistent Disparities in Colorectal Cancer Screening among Racially and Ethnically Diverse Populations.”
Expert panelists offered diverse opinions on a number of areas, including quality, value, and payment, advocacy, research, and innovation in colorectal cancer (CRC) screening.
During the webinar NEHI's Claire Cruse highlighted key findings from the report, including the short- and long-term recommendations made in the report. From there, experts discussed data aggregation and how it plays a role in tackling disparities in CRC screening, quality, and payment challenges, including a discussion of the Braidwood decision, and a look ahead to future priorities and topics of interest.
- 📊 Panel 1: Data Aggregation Challenges: Explore the role of data collection and aggregation in closing disparities with experts from Kaiser Permanente Center for Health Research and Colorectal Cancer Alliance.
- 📉 Panel 2: Quality and Payment Challenges: Learn about quality and payment challenges, including the potential impact of the Braidwood decision, with experts from NCQA and Epstein Becker Green.
- 🧪 Panel 3: Emerging Research and Evidence: Discover emerging research priorities and evidence with experts from Exact Sciences Corporation, University of Michigan, and Kaiser Permanente Washington Health Research Institute.
It's Time to Plan for Value-Based Delivery of Obesity Treatment And Support
June 8, 2023
- Angela Fitch, MD, President, Obesity Medicine Association; Co-founder and Chief Medical Officer, Knownwell Health
- Florencia Halperin, MD, Chief Medical Officer, Form Health
- Tracy Zvenyach, Ph.D., MS, RN, Director of Policy Strategy & Alliances, Obesity Action Coalition
- Mark Japinga, Research Associate, Duke-Margolis Center for Health Policy
The Coming Impact of Innovation in Diagnostic Tests and Tools on Alzheimer's Disease and Dementia Screening, Diagnosis, and Treatment
May 25, 2023
Innovative new tests for Alzheimer’s are now emerging or in development, including innovations in cognitive behavioral assessment, imaging, blood-based testing, and other modalities. They will play a major role in shaping the course of screening, diagnosis, and treatment for Alzheimer’s and dementia services in the coming years.
NEHI's Tom Hubbard and Lauren Bedel hosted a convening with leading experts working in this area. Topics addressed included the current and emerging capabilities to identify Alzheimer's disease at stages when dementia care treatment is most likely to be effective, overcoming shortages in the specialist workforce, finding clinically-effective and cost-effective policies that overcome current restrictions, and creating a pathway to comprehensive care, including the best use of available diagnostics at key stages of disease progression.
Automating Prior Authorization Across Massachusetts: We can do this, together
May 24, 2023
After concluding a year-long project that included stakeholders from the payer, provider, technical service provider, and federal and state regulator communities, NEHI and the Massachusetts Health Data Consortium (MHDC) shared recommendations for automating prior authorization across Massachusetts.
Webinar speakers included:
- Wendy Warring, JD, CEO, NEHI
- Lauren Bedel, MPH, Senior Health Policy and Program Associate, NEHI
- Denny Brennan, Executive Director & CEO, MHDC
- David Delano, Senior Director, MHDC and Executive Director, New England Healthcare Exchange Network
Taking Stock of Adult Vaccination in the U.S.
October 11, 2022
As the COVID-19 pandemic nears its third anniversary, what is the state of vaccination among adults in the United States?
Rapid development and deployment of COVID-19 vaccines saved hundreds of thousands of lives in the U.S. and greatly reduced serious illness. Yet, millions of U.S. adults have missed routine, non-COVID vaccinations since the onset of COVID-19, exposing them to the risk of vaccine-preventable diseases.
Promising developments in adult vaccination include the elimination of patient co-pays for vaccinations covered by the Medicare prescription drug program. Novel vaccines will likely be introduced in the months ahead that protect against diseases for which no vaccine exists today, and new vaccine combinations could make vaccination more convenient for patients. But the U.S. continues to face an urgent need to restore and improve vaccination rates across all CDC-recommended vaccines, and to prepare for future pandemic threats.
In this webinar, we explore the state of adult vaccination in the U.S. and examine the prospects for raising vaccination rates among Medicare beneficiaries and other U.S. adults.
Our panel includes:
- Abby Bownas: Co-Manager, Adult Vaccine Access Coalition
- Kathryn Hashey, MA, MPH: Director of Vaccine Policy, GSK
- Sean Gallagher: Senior Principal, IQVIA
- Jewel Mullen, MD: Associate Dean for Health Equity and Associate Professor of Population Health and Internal Medicine, University of Texas Dell Medical School; Member, National Vaccine Advisory Committee
Accelerating and Enhancing Behavioral Health Integration through Digitally Enabled Care
August 2, 2022
The COVID-19 pandemic exacerbated a behavioral health crisis across the country, acutely impacting children and teens. Despite the need for increased access to behavioral health services, there is a severe shortage of providers. In this webinar, the AMA and Manatt Health expanded on their joint report on the opportunities and challenges of accelerating behavioral health integration (BHI) through digitally enabled care.
Among the topics addressed:
- Examples from innovators and researchers applying practical solutions for supporting the widespread adoption of BHI
- The ways technology can be used to advance BHI adoption and impact, including a review of both opportunities and limitations
- Solutions for addressing the gaps hindering BHI adoption
- A guide to demonstrating value by applying the AMA’s Return on Health Framework to digitally enabled BHI
Speakers:
- Jared Augenstein, Director, Manatt Health
- Lori Evans-Bernstein, CEO and Co-founder, Caraway
- Chris Botts, Manager, Care Delivery/Payment, AMA
- Virna Little, PsyD, LCSW-r. COO and Co-founder, of Concert Health
- Wendy Warring, JD, President and CEO, Network for Excellence in Health Innovation
Tele-mental Health Care Among Medicaid Enrollees
June 22, 2022
We feature participants from the three stakeholder groups represented at the convening: providers, payers, and patients or individuals with lived experience of mental or behavioral health conditions. Joining these panelists were industry experts in telehealth.
- Jared Augenstein – Director, Manatt
- Katia Canenguez, Ph.D., EdM – Pediatric Psychologist, MGH; Clinical Researcher, MGH Mongan Institute; Instructor, Harvard Medical School
- Heather Carter – Administrator, Health Care & Rehab Services, Hartford VT
- Allison Frank – Member, Genesis Club, Worcester MA
- Heather Meyers, MBA – Director, Virtual Care, Innovation and Digital Health Accelerator, Boston Children's Hospital
- Tamara Lundi, MHA – President & CEO, Community Healthlink
- Elizabeth Ross, MD – BH Medical Leader, Office of the CMO, Point32Health
NEHI Member Briefing: Health Equity, Data, and Value-Based Payment
May 26, 2022
Can health equity goals become part of the movement towards value-based payment in U.S. health care?
This NEHI member roundtable highlighted efforts to make health equity a vital part of value-based care. The discussion centered on data-driven initiatives launched by NEHI members to close health disparities and the goals that public and private sector payers have outlined for achieving equity through payment reforms.
Our discussion panel included Dr. Nora Dennis, Lead Medical Director for Behavioral Health and Health Equity at Blue Cross Blue Shield of North Carolina; Christina Severin, MPH, President & CEO at Community Care Cooperative; and Melissa Sherry, Ph.D., MPH, Vice President, Social Care Integration at Unite Us.
Addressing Barriers Associated with Increasing Diversity and Inclusion in Clinical Studies
May 18, 2022
Hosted by Wendy Warring, NEHI's President and CEO. This discussion panel, which was hosted by NEHI's Wendy Warring was featured at InformaConnect's digital event, Ensuring Diversity & Inclusion for Clinical Trials. This panel covered:
- Factors affecting participation: Socio-economic background, language, trust, and accessibility
- Starting points in addressing barriers
- Examples of successfully implemented programs that increased trust and participation from diverse groups in trials
- Issues encountered when addressing these barriers
Smarter Health Care Coalition 2022 Virtual Policy Summit
April 7, 2022
NEHI's Vice President of Policy Research, Tom Hubbard, participated in the panel discussion "Obesity Care: Payment and Benefit Design Innovations to Improve Prevention and Treatment of Obesity."
In contrast to a one-size fits all cost-sharing approach that could reduce the use of high-value services and worsen health disparities as it relates to obesity, there is an important opportunity for V-BID to address this growing chronic illness. Recent studies have shown that reducing financial barriers to improve medication adherence in particular can have a significant impact on patient-centered outcomes for those with obesity. This panel explored a range of V-BID approaches focused on addressing obesity as well as current health equity implications.
Next Steps Toward Patient Focus in Value Assessment and Payer Decision-Making
March 24, 2022
Decision makers – specifically payers and purchasers – are increasingly aware of the importance of accounting for patient and family experience and preferences, but the methods for doing so remain unclear. IVI and NEHI convened two stakeholder forums* to consider the complex issues of defining, sharing, and integrating patient data and insights into the decision-making process. This webinar highlighted key learnings and identified guideposts for action that evolved from both initiatives.
* Both convenings were partially funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington PCORI® Engagement Award (#EAIN-21156 and #EAIN-1998).
NEHI Member Briefing: Patients and Health Care Payers: How should they communicate with each other when novel therapies are approved?
December 1, 2021
The U.S. Food and Drug Administration has approved dozens of novel drugs and, by most estimates, dozens more will be approved in the years ahead. Many promise to be transformative, even curative therapies for serious unmet medical needs. Some also trigger complex and difficult decision-making on coverage by health care payers concerning the cost of new therapies and the depth of evidence supporting their use.
With support from the Patient-Centered Outcomes Research Institute (PCORI), NEHI convened patient and health care payer leaders to identify principles of trustworthy communication regarding decision-making on coverage of novel therapies. In this briefing, NEHI Vice President of Policy Research Tom Hubbard presented results from the project, with comments from three experts:
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Jennifer Graff, PharmD, Senior Director of Professional Affairs at the Academy of Managed Care Pharmacy
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Annie Kennedy, Chief of Policy and Advocacy at the EveryLife Foundation for Rare Disease
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Donna Messner, PhD
The NEHI project on patient-payer communication is supported by a Patient Engagement Award (Project EAIN 19981) from the Patient-Centered Outcomes Research Institute (PCORI).
NEHI Member Briefing on Prior Authorization: Can we all be happier?
December 15, 2021
In this briefing, hosted by NEHI President and CEO Wendy Warring, we reported on the recommendations from our 9-month project on prior authorization. The project’s goal was to develop consensus for feasible reforms among members of a Steering Committee that included providers, payers, and representatives of employer and consumer organizations. The discussion included the perspectives on the suggested reforms from individuals who have studied prior authorization and worked to improve it.
Briefing participants included:
- Kate Berry, Senior Vice President of Clinical Affairs and Strategic Partnerships, AHIP
- David Culter, Committee Chair, Massachusetts Health Policy Commission
- Heather McComas, Director of Administrative Simplification, American Medical Association
- Sandhya Rao, Chief Medical Officer, Blue Cross Blue Shield of Massachusetts
- Nikhil Sahni, Partner, McKinsey & Company
Psychedelic Medicine: Old Compounds, New Beginnings
July 14, 2021
NEHI's Wendy Warring led a discussion with panelists representing academia and industry to explore the research and multitude of issues surrounding psychedelic medicine and its use to treat mental health conditions, including PTSD and depression. This overview of the discussion summarizes the promise and the issues, which include cost and coverage for treatments, recruiting and training an appropriate workforce, and ongoing efforts to de-stigmatize psychedelic compounds and mental health more broadly.
Webinar panelists included:
- Mike Apkon, MD, PhD, MBA, President, Sand Street Advisors; NEHI Board Member
- Joy Sun Cooper, Head of Commercialization and Patient Access, MAPS Public Benefit Corporation
- Dan Grossman Managing Partner, Boston Consulting Group
- Joseph del Moral, Co-Founder and Chief Executive Officer, Field Trip
- John Krystal, MD, Chair and Chief of Psychiatry, Yale-New Haven Hospital
- Neil Leibowitz, MD, JD, Chief Medical Officer, Beacon Health Options
- Wendy Warring, JD, President and CEO, NEHI
Advancing Integrated Behavioral Health and Primary Care: Persistent Challenges and Potential Solutions
May 20, 2021
There is broad interest and significant investment in integrating behavioral and primary care among professional organizations, CMS, payors, and providers. Yet, despite over two decades of convincing evidence about its value and cost-effectiveness, the adoption of integrated behavioral health care is proceeding slowly. What are the barriers to scaling a solution that appears critical to addressing our nation’s behavioral health needs? What are the solutions we can implement today? What is the advocacy we need for tomorrow?
NEHI's Wendy Warring led a discussion with individuals who have been working on integration issues for much of their careers to explore how to build on key areas of agreement to highlight and promote critical first steps.
Participants included:
- Ben Miller, PsyD, Chief Strategy Officer, Well Being Trust
- Diane Powers, MBA, MA, Co-Director, AIMS Center, University of Washington School of Medicine Department of Psychiatry and Behavioral Sciences
- Matthew Press, MD, MSc, Physician Executive, Penn Primary Care and Medical Director, Primary Care Service Line, Penn Medicine
- Ann Greiner, President, and CEO, Primary Care Collaborative
- Lindsay Henderson, PsyD, Director of Psychological Services, Amwell
- Mark Wenneker, MD, MPH, Principal, The Chartis Group
- Hyong Un, MD, Chief Psychiatric Officer and Head of Product Innovation, Aetna Behavioral Health
- Katherine Knutson, MD, MPH, Senior Vice President, United Health Group and CEO, Optum Behavioral Care
- Nora Dennis, MSPH, MD, Lead Medical Director, Behavioral Health, BCBSNC
- Wendy Warring, JD, President and CEO, NEHI
- Virna Little, PsyD, LCSW-R, Co-Founder and Chief Operating Officer, Concert Health
- Josh Israel, MD, Medical Director of Behavioral Health, Aledade, Inc.
- Chris Molaro, CEO and Co-Founder, NeuroFlow
- Carol Alter, MD, System Leader, Behavioral Health, Baylor Scott & White Health; Senior Fellow, Meadows Mental Health Policy Institute
Health Care Without Walls Convening
May 10, 2017 - Kaiser Permanente Center for Total Health 700 Second St. NE Washington, DC
As the U.S. health care system shifts towards value-based care and payment, and technology enables everything from telehealth to collecting biometric data from smartphones, pushing health care out of institutions and closer to consumers and patients has become a priority for many health system stakeholders. Providers and payers recognize that new modalities of care delivery may not only address consumers’ desire for convenience but could also lead to greater access at reasonable costs. “Health care without walls” could hold out particular benefits for the frail elderly and other vulnerable populations; for underserved areas of the country; and for advancing population health strategies aimed at addressing not just health care needs, but social determinants and other upstream drivers of health.
There are already many forces and “enablers” pushing toward “health care without walls,” but also many obstacles. Put simply, if it were up to technology alone, “health care without walls” would be a reality today for much of health care; the fact that it does not underscore that barriers exist. Over 2017-2018, The Network for Excellence in Health Innovation (NEHI) will work to advance a research and thought leadership agenda and identify opportunities to overcome the obstacles.
NEHI Members and others are invited to attend this convening, hear from a select group of presenters, participate in small group discussions, and help refine the plan for the work streams that will carry out the project.