Report: New York State Medicaid spending on dementia care most in the nation


New York spends more Medicaid dollars on care for Alzheimer’s disease or other dementias than any other state in the nation, according to a new report from the Alzheimer’s Association.

The 2019 Alzheimer’s Disease Facts and Figures report — available at — finds that New York will make more Medicaid payments for adults age 65 and older living with a form of dementia — $5.037 billion — this year than any other state. California, $3.925 billion; and Pennsylvania, $3.543 billion, follow the Empire State.

“It echoes something we have told policymakers and elected officials for years,” said Catherine James, chief executive officer for the Alzheimer’s Association, Central New York Chapter. “Alzheimer’s disease will bankrupt the health care system in America. It’s not a matter of whether, but a matter of when.”

New York’s payments represent more than 10 percent of the $49 billion Medicaid will spend on Alzheimer’s care in 2019. The report estimates the cost of care for Americans with Alzheimer’s disease or other dementias age 65 or older at $290 billion this year.

Medicare will foot more than half of the national bill at $149 billion. Individuals and families will pay $63 billion out-of-pocket, while private insurance, managed care organizations, and health care maintenance organizations (HMOs) will spend $11 billion.

“Alzheimer’s disease is the most expensive disease in America and the toll is rising,” James said.

“But, what we also know is that programs and services like those provided by the Alzheimer’s Association can help delay placement in long-term care facilities, which reduces the burden on Medicaid and keeps the individual living with dementia in a familiar environment.”

Findings from the report show more than 5.8 million Americans, including 400,000 in New York have Alzheimer’s disease.

New York has the third-highest total nationally behind only California, 670,000; and Florida, 560,000. If no prevention or cure is found, the state’s Alzheimer’s population is estimated to rise 15 percent to 460,000 by 2050.

The report revealed New York is one of four states with more than 1 million people serving as an unpaid caregiver to someone living with dementia. The state’s 1,041,000 caregivers accounted for 1.15 billion hours of unpaid care at an estimated economic value of nearly $14.6 billion.

The report also shows that, despite a strong belief among seniors and primary care physicians that brief cognitive assessments are important, only half of seniors are assessed for thinking and memory issues, and much fewer receive routine assessments.

A survey conducted by the Alzheimer’s Association shows that just 1 in 7 seniors, or 16 percent, said they receive regular cognitive assessments for memory or thinking issues during routine health checkups, even though an evaluation of cognitive function is a required component of the Medicare Annual Wellness Visit.

Other assessments are more regularly performed, including blood pressure (91 percent), cholesterol (83 percent), vaccinations (80 percent), hearing or vision (73 percent), diabetes (66 percent) and cancer (61 percent).

A brief cognitive assessment is a short evaluation for cognitive impairment performed by a health care provider that can take several forms — including asking a patient about cognitive concerns, directly observing a patient’s interactions, seeking input from family and friends or using short verbal or written tests that can be administered easily in the clinical setting. 

Nearly 2,000 individuals age 65 and older were surveyed in December 2018 for the study. An additional 1,000 primary care physicians were included on a related review. Fewer than half of those respondents, or 47 percent, said it is their standard protocol to assess all patients age 65 and older for cognitive impairment.

Only 1 in 4 seniors, or 26 percent, report having a physician ever ask them if they have any concerns about their cognitive function without seniors bringing it up first.

Full text of the 2019 Alzheimer’s Disease Facts and Figures report, including the accompanying special report, Alzheimer’s Detection in the Primary Care Setting: Connecting Patients with Physicians, can be viewed at


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