Value Based Care: An Opportunity for Geriatric Psychiatrists to Become Healthcare System Leaders

Abstract

The American population is rapidly aging. As of 2021, there are approximately 46 million adults over the age of 65 and it is projected that by 2050 the number will nearly double to 90 million. According to the WHO, rates of mental illness are also increasing: At present, about 20% of adults over 60 suffer from psychiatric or neurological disorders. According to the Alzheimer's Association, in 2021 there are about 6.2 million Americans 65 and older living with AD by 2050 that number will expand to about 12.7 million. The population of older adult Americans who currently need and will need access to high quality psychiatric care is astounding. The 50 or so new geriatric psychiatrists who complete fellowship training annually are unable to manage the rapidly aging population in a fee-for-service environment given the sheer scale of the patient population. The Alzheimer's Association data points out that the disparities are much deeper than just a deficit of geriatric psychiatrists. About one-third of Black Americans one-fifth of Hispanic and Asian Americans believe they would be discriminated against while attempting to access Alzheimer's care. Hispanic, Black and Native Americans are twice as likely as Whites to say they would not see a doctor if experiencing thinking or memory problems. One in five Black and Hispanic Americans say they would feel insulted if a doctor suggested a cognitive assessment. Value based care (VBC), the idea that healthcare delivery should be reimbursed based on quality of care and outcomes, rather than encounters, offers a future where geriatric psychiatrists can play a prominent role in determining how psychiatrist disease is managed across large populations. Novel care delivery models that increase access to high quality care for the entire population have the potential to transcend health disparities and bring geriatric psychiatry to the forefront. In this symposium, we will learn about the concept of VBC, the interface of geriatric psychiatry with VBC, the roles that some geriatric psychiatrists are already taking in VBC healthcare delivery, and how VBC programs are implemented and assessed.