A telecare program developed by the University of California, San Francisco (UCSF) has been found to improve outcomes for patients with dementia while also reducing Medicare costs. The program, called Care Ecosystem, provides medical and practical assistance to patients with dementia and supports their unpaid caregivers.
In a study published in JAMA Internal Medicine, researchers compared the Medicare costs of 780 dementia patients who were randomized to receive Care Ecosystem support or usual care over a 12-month period. The study found that the average monthly Medicare cost per patient in the Care Ecosystem group was $526 lower than in the usual care group.
The Care Ecosystem program, which was implemented by UCSF in 2014, connects patients and caregivers with a navigator who helps troubleshoot issues and conveys instructions from clinicians and experts. Navigators assist with medication and symptom management, daycare placement, respite care, transportation, and home safety.
Starting from July 2024, the UCSF telecare program, along with similar initiatives, will be available to dementia patients covered by Medicare fee-for-service or dual Medicare-Medicaid eligibility who are living at home or in assisted living facilities.
The study’s findings are particularly significant considering the challenges faced by unpaid caregivers and the potential impact on their mental, physical, and financial well-being. The Care Ecosystem program aims to shift the caregiver system from crisis-oriented to proactive care.
The study also highlighted the significant benefits of the program for patients with moderate-to-severe dementia and caregivers experiencing depression. Meeting with a navigator and clinical team led to cost savings by averting unnecessary visits to the emergency room. Patients who visited the ER more frequently were more likely to benefit from working with a navigator.
UCSF’s Care Ecosystem program has already been replicated by over 25 organizations, and a payment model called GUIDE is set to provide funding to UCSF and other institutions offering similar telecare services. GUIDE has the potential to transform the lives of millions of Americans living with dementia and their unpaid caregivers.
This research reinforces the importance of care navigation in improving overall quality of life for patients with dementia and their caregivers, at all stages of the disease. The Care Ecosystem program offers hope without side effects or burdens associated with medications.
– Study published in JAMA Internal Medicine
– University of California – San Francisco