Systems Delivery Innovation for Alzheimer Disease

Nicholas T. Bott, Clifford C. Sheckter, Daniel Yang, Stephanie Peters, Brian Brady, Scooter Plowman, Soo Borson, Bruce Leff, Robert M. Kaplan, Terry Platchek, Arnold Milstein

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objective: The authors describe a comprehensive care model for Alzheimer disease (AD) that improves value within 1–3 years after implementation by leveraging targeted outpatient chronic care management, cognitively protective acute care, and timely caregiver support. Methods: Using current best evidence, expert opinion, and macroeconomic modeling, the authors designed a comprehensive care model for AD that improves the quality of care while reducing total per capita healthcare spending by more than 15%. Cost savings were measured as reduced spending by payers. Cost estimates were derived from medical literature and national databases, including both public and private U.S. payers. All estimates reflect the value in 2015 dollars using a consumer price index inflation calculator. Outcome estimates were determined at year 2, accounting for implementation and steady-state intervention costs. Results: After accounting for implementation and recurring operating costs of approximately $9.5 billion, estimated net cost savings of between $13 and $41 billion can be accomplished concurrently with improvements in quality and experience of coordinated chronic care ($0.01–$6.8 billion), cognitively protective acute care ($8.7–$26.6 billion), timely caregiver support ($4.3–$7.5 billion), and caregiver efficiency ($4.1–$7.2 billion). Conclusion: A high-value care model for AD may improve the experience of patients with AD while significantly lowering costs.

Original languageEnglish (US)
Pages (from-to)149-161
Number of pages13
JournalAmerican Journal of Geriatric Psychiatry
Issue number2
StatePublished - Feb 2019

Bibliographical note

Funding Information:
We would like to thank David S. Hopkins, Chris Callahan, Emily Finlayson, and Jennie Chin Hansen for their mentorship and input on this project. This manuscript was supported by funding from NIH (UL1 TR-001085). The authors have no financial conflicts of interest to disclose.

Publisher Copyright:
© 2018 American Association for Geriatric Psychiatry


  • Alzheimer disease
  • care delivery
  • Care design
  • healthcare policy
  • high-value care

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


Dive into the research topics of 'Systems Delivery Innovation for Alzheimer Disease'. Together they form a unique fingerprint.

Cite this