How to Save Millions in Hawaii Medicaid Dollars

Dear Governor Abercrombie,

My name is Dr. Tom Harding, a fellow public servant. I am a forensic neuropsychologist working for the Department of Health, Adult Mental Health Division.

You spoke to us during a luncheon at the Hawaii Pacific Gerontological Society this past October, 2010.

Briefly, I want to bring your attention to a topic that I’m sure you are aware of- the rising costs associated with the increasing numbers of baby boomers who are predicted to succumb to Alzheimer’s disease and related dementias (ADRD).

The graph below shows that increased hospital stays due to medical complications account for a significant portion of the increased costs associated with ADRD.

The bulk of those costs will have to be paid for by Medicare and Medicaid dollars.

It is known that a 600% increase in Medicaid dollars is associated with every ADRD case (see following chart).





The strategy to save millions in Hawaii Medicaid dollars is a simple one- reduce the number of future dementia cases.

Now that years of research have resulted in no cure for ADRD, the scientific community is turning its attention towards early intervention strategies in an effort to prevent, or at least delay, the onset of ADRD.

Studies such as the one below are indeed showing a positive outcome for interventions to delay the onset of ADRD.







Researchers have reported that if we can delay the onset of ADRD by 5 years we can reduce the number of future cases by 50%.

Age is the greatest risk factor for ADRD.

Hawaii has the 2nd oldest population per capita in the nation.

Yet Hawaii currently has nothing in place to address critical issues such as determining the number of future dementia cases (i.e. a dementia registry like South Carolina), or the implementation of strategies on how to reduce those numbers via early intervention.

Being community minded, I have been involved with geriatric boards on Maui and Oahu and network with many agencies that are concerned about this looming problem.

I have discovered that there is not a venue for various key stakeholders to come together.

I am suggesting that a governor’s “Dementia Task Force” be created to bring stake holders together such as the state’s Executive Office on Aging (EOA) and community organizations such as HMSA, UH School of Geriatrics, etc.

The task force could determine the predicted ADRD numbers and costs, and how to go about reducing those costs (resulting in millions saved) through early intervention strategies.

A Dementia Task Force will bode well for the new administration at a time when retirees are concerned for their future.

I believe that if state and community stakeholders had the opportunity to come together and work as a team, we could make a real difference in the prevention and delay of ADRD.

And with that success, the state will save millions, and the current administration will be professed as nothing less than a champion administration for having foresight and being proactive.

The alternative is for Hawaii to do nothing and be hit by the boomer's silver tsunami and hope the already ailing State economy can somehow survive.

I have already met with the medical director and other executives of HMSA, and they are willing to meet with the state EOA and other community stakeholders to see how we as a ‘village’ can work together to survive what HMSA's medical director dubbed, the "perfect storm."

If this idea appeals to you Governor, I am willing meet with a few key people to draft an outline of what the governor’s ‘Dementia Task Force’ might look like as a starting point.

I have already spent a great amount of time and energy researching optimal strategies for preventing ADRD.

I even published a book last November that you can see at: www.Be-Dementia-Free.com

Please do not order a copy, it would be an honor for me to personally provide you with a signed copy.

I hope to hear from you soon on this vital (and potentially expensive) matter.

Respectfully submitted,

Dr. Tom Harding, Psy.D., M.A.

Forensic Neuropsychologist

Brain Rehabilitation Specialist

Adult Mental Health Division, Hawaii Dept. of Health

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