Advancing Neurological Care Through Payer, Provider Collaboration

At an Institute for Value-Based Medicine® (IVBM) event held in partnership with The American Journal of Managed Care® (AJMC®) and University of Colorado Anschutz Medical Campus, Katherine Coerver, MD, PhD, FAAN, neurologist, Rocky Mountain Neurology, discussed some of the most pressing issues in neurological care.

The event was held on August 22, 2024, in Aurora, Colorado.

Transcript

As a neurologist who specializes in patients with cognitive issues, such as Alzheimer disease, what do you believe are some of the biggest gaps in neurological care?

The biggest gap is education for both patients and providers, because many patients don't realize that they are experiencing memory problems, and they are not seeking medical attention. We know that early intervention is what is best when it comes to memory issues. So, educating people about how memory problems can present when they present, and making certain that they realize talking to their doctors is incredibly important. Also, education to providers, especially our primary providers: just because somebody is 70 [years], that doesn't mean that they have memory complaints; making certain that they get the evaluation they need and the referral that they need, so that their memory problems get worked up correctly.

Following the FDA’s approval of anti-amyloid drugs, how do you assess the long-term benefits and potential risks of these drugs, especially considering their impact on cognitive function and overall quality of life in patients?

Since these medications have not been available for long, we are still assessing the long-term impacts. It will be continuing to follow people when they receive these medications, which is why they have registries in place, so that we can determine: Are there ongoing benefits with these medications? Can you eventually stop the medications? Will the patients continue to have a slower progression, or do we need to think of adding another medication or reintroducing the medication?

How can payers and providers make sure these treatments are more accessible to patients?

Open lines of communication, making certain that the payers realize what interventions are needed to help our patients. That goes with the testing before to prove that somebody has the Alzheimer's disease pathology and making certain that they have the monitoring that they need if they are receiving the therapy. Making certain if the payers have any concerns, that they actually talk to the providers, so that we can address any of these concerns, and hopefully not run into a situation where a person's medication would have to be stopped.

What are best practices providers can adopt to involve patients in the decision-making process when it comes to new neurological treatments?

I'm going to sound like a broken record, but it's education and open lines of communication. People need to be aware of what interventions are available. What is the appropriate patient to receive these interventions? What are the risks and benefits? What is involved in receiving them, making certain they have all of the information they need to make an informed decision, but also making yourself available? So, if they have questions concerning it, they can reach out to you.

How do innovations in neurological treatments integrate with other aspects of patient care, such as primary care or mental health services?

The more interventions we have, especially to help people with a disease like Alzheimer's, the more we need to keep our lines of communication open with primary providers and mental health providers, because sometimes people with memory issues will initially present to a psychiatrist or a mental health professional. So, making certain everybody is aware of what interventions are available, so that they get to the correct place to see would they benefit from a different intervention.