A growing number of states have now decided to expand their managed care programs to encompass Long-Term Services and Supports (LTSS). From 2004 to 2012, the number of states with Medicaid managed LTSS (MLTSS) programs doubled from eight to 16, and ten more states are projected to implement MLTSS programs by 2014. 1 With this move comes a major
Contracts with managed care organizations (MCOs) in 17 states were reviewed. The scan of managed long-term services and supports (MLTSS) quality requirements revealed wide diversity in some instances and in others more convergence. Also, whereas contracts may require the same quality elements, in one state the requirement may be very specific and
The following acronyms are mentioned in this report and/or appendices.
This report describes how frequently various quality requirement elements appear in managed care organization contracts, as well as some similarities and differences in the quality requirements.
Alzheimer's Association. (2011). "2010 Alzheimer's Disease Facts and Figures." Retrieved May 11, 2012, from http://www.alz.org/documents_custom/report_alzfactsfigures2010.pdf . Alzheimer's Association. (2012). "2011 Alzheimer's Disease Facts and Figures." Retrieved May 11, 2012, from http://www.alz.org/downloads/facts_figures_2011.pdf .
This paper reviews the research literature on ethnic and racial disparities as it relates to Alzheimer's disease. The literature shows consistent and adverse disparities among Blacks and Hispanics compared to non-Hispanic Whites in the prevalence and incidence of Alzheimer's disease, mortality, participation in clinical trials, use of medications
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Outreach to Minority Communities
Another approach to addressing disparities involves targeting programs and outreach to minority populations. For example, the Alzheimer's Disease Demonstration Grants to States program provided demonstration grants to Florida, Kentucky, and the District of Columbia, that focused on African Americans (Wiener & Mitchell, 2007). For example, in t
Cultural competency is especially important in the health care setting, where barriers to communication and access to quality care can result in delayed diagnosis, inappropriate treatment, or worse. Cultural competence involves both awareness and knowledge about other cultures and skill in relating to people of other cultures. Cultural competence
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Interventions to Reduce Racial and Ethnic Disparities
Although there is extensive evidence documenting disparities among different racial and ethnic groups with Alzheimer's disease, there are few studies evaluating interventions to address disparities in this population. Almost all interventions designed to explicitly address racial and ethnic disparities focus on cultural competency on the part of t
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Racial and Ethnic Discrimination
Although discrimination by providers against racial and ethnic minorities in the United States is commonly asserted as the cause of racial and ethnic disparities, we were unable to find any empirical studies on this topic that focused on people with Alzheimer's disease. Indeed, there appear to be few empirical studies on this topic in health care.
Culture has been defined as a group's values, beliefs, traditions, symbols, language, and social organization (Harwood & Ownby, 2000). The United States model of health care, which values autonomy in medical decision making, contrasts with preferences for more family-based, physician-based, or shared physician and family-based decision making
Parental or early life socioeconomic position, childhood IQ, measures of early growth (such as infant head circumference and childhood height), educational attainment, occupational characteristics, and various measures of social integration have all been linked to cognitive function and neurocognitive disorders in adulthood and old age (Glymour &a
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Cardiovascular and Cerebrovascular Disease
Vascular factors and conditions that may be associated with cognitive decline and dementia include stroke, diabetes, hypertension, congestive heart failure, high fat intake, high cholesterol, smoking, alcohol misuse, atrial fibrillation, low folate, and obesity (Glymour & Manley, 2008). Although there is no definitive evidence linking cardiova
APOE is a gene that comes in a normal or neutral form (allele), known as E3, and two variants, E2 and E4, which have been implicated in vascular and Alzheimer's diseases. The E4 variant is the most important known genetic risk factor for Alzheimer's disease.
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Factors Related to Measurement of Alzheimer's Disease Prevalence and Incidence
The historically higher prevalence rates for community-dwelling African Americans than for Whites may be partially attributable to the measurement of disease prevalence and incidence. For example, historically, lower institutionalization rates among African Americans in the past left more people with dementia in the community, whereas comparable W
Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Possible Reasons for Racial and Ethnic Disparities
Possible reasons for racial and ethnic disparities include factors related to measurement of Alzheimer's disease, genetics, cardiovascular and cerebrovascular disease, socioeconomic factors, cultural differences, and racial and ethnic discrimination. A range of pathways have been suggested that link race and ethnicity with cognitive impairment, so
To identify relevant studies, we searched PubMed, Google Scholar, and our in-house electronic library for peer-reviewed articles and research reports published in English through 2014 related to the Alzheimer's population and their caregivers. We also searched the Internet for gray literature using similar search terms.
Existing evidence for Alzheimer's disease and related dementias suggests that there are significant differences in prevalence, incidence, treatment, and mortality of Alzheimer's disease across racial and ethnic groups. There are also substantial differences in participation in clinical trials, the use of services, and disease-related expenditures.
The following acronyms are mentioned in this report.
This study aimed to describe and characterize the published literature on disparities between racial and ethnic groups among individuals with Alzheimer's disease and related dementias. To identify relevant studies, we searched electronic sources for peer-reviewed articles and research reports published through 2014 related to the Alzheimer's popul