Objective:

The Brain Health Navigation (BHN) program is designed to improve the care and experience for patients and caregivers through the development of a boundary-spanning program across primary and specialty memory care in a financially sustainable model.

Background:

Approximately 7 million Americans aged 65 and older suffer from Alzheimer’s disease, with numbers continuing to increase. Healthcare systems are fragmented and ill-prepared for the approaching tsunami. A navigation program spanning primary and specialty is one possible solution to the need for improved identification, evaluation and coordination of care for those with dementia, as well as caregiver support.

Design/Methods:

In partnership with a pilot primary care practice and the Memory Center of the Norton Neuroscience Institute in Louisville, Kentucky, we developed a brain health navigation program as one of six sites participating in the Davos Alzheimer’s Collaborative Healthcare System Preparedness BHN program. Our program focused on addressing current care gaps, creating value for patients and caregivers, allowing for flexibility of practice and identifying revenue generation opportunities to ensure financial sustainability. Initial duties of the brain health navigator included coordination across sites of care, facilitation of diagnostic testing, caregiver education and support, advanced care planning, and coordination with additional resources, both internal and external. We focused on Principal Illness Navigation (PIN) and Principal Care Management (PCM) codes for reimbursement. 

Results:

In the first 6 months of operation, 103 patients were enrolled in the navigation program. Patient and caregiver satisfaction has been high. PIN/PCM codes have been routinely reimbursed. Approximately 25% of patients have enrolled in anti-amyloid therapies. 

Conclusions:

Brain Health Navigation is a possible solution and well accepted in facilitating more efficient diagnostic evaluation and increasing patient/caregiver satisfaction. Early experience indicates financial sustainability, particularly when considering both reimbursement of navigation services along with downstream revenues (e.g., MRI, labs, anti-amyloid therapies).