Healthcare Financing and Delivery Innovation

ATI Advisory in partnership with the Rosalynn Carter Institute for Caregivers (RCI) sought to explore the evidence and needs of dementia caregivers that might inform a Medicare model test related to dementia care. On July 31, 2023, the Center for Medicare and Medicaid Innovation (CMMI) released the Guiding an Improved Dementia Experience (GUIDE) Model that includes explicit support for caregivers and is set to launch in July 2024.

Sarah Rosenblum and Allison Rizer explain how CAPABLE is a data-tested tool for dual eligible integration and pathways for state Medicaid programs to implement the program.

Anna Kaltenboeck writes for Health Affairs on the ways in which the Centers for Medicare and Medicaid Services can define and select drugs for the first round of prescription drug negotiations on September 1, 2023.

ATI Advisory identifies what sets apart individuals with Long Term Care (LTC) needs from the rest of the Medicare population. This work examines the demographic profiles, care complexity, medications, and medical and pharmacy spending for Medicare beneficiaries receiving LTC in different settings, as well as for Medicare beneficiaries who do not receive LTC.

Few drugs have triggered as much controversy and debate as those for Alzheimer’s Disease. So, it should come as no surprise that last week’s update from Centers for Medicare and Medicaid Services (CMS) on its coverage for these treatments would trigger a wide range of responses. Some outlets reported that CMS was broadening its coverage, even as other groups stated that the agency was limiting access. Others argued that the update heralded no change at all.

This is the final episode of the ATI podcast series, "The Intersection of Primary Care and Senior Care". Fred Bentley, ATI Managing Director of Medicare Innovation, and Peter Longo, Principal and Managing Partner at Cantex Continuing Care Network, discuss how Cantex evolved from a multi-facility skilled nursing provider to a full-service continuing care network. In this second of two episodes, Peter explains Cantex's primary care model and the strategic value of primary care in their senior living settings.