# Understanding the CHANGE Act of 2021

The CHANGE Act focuses on catching Alzheimer's disease and related dementias earlier so people can get help sooner. Right now, many people with early signs of memory problems don't get diagnosed until the disease is more advanced. This bill tries to change that by making cognitive testing a standard part of Medicare checkups for older adults.

Starting in 2022, when Medicare patients go in for their annual wellness visit or initial physical exam, doctors will be required to screen them for cognitive impairment using validated testing tools. If a doctor spots potential problems, they'll refer the patient to specialists, diagnostic services like brain imaging, and support services. The idea is that catching these issues early—before someone develops full dementia—gives them time to plan their care, explore treatment options, and potentially enroll in clinical trials that might help. Doctors will also be encouraged to discuss lifestyle changes that research shows can help prevent or delay dementia, like exercise, staying mentally active, managing blood pressure, and eating well.

The bill also changes how Medicare rewards doctors and health plans. Starting in 2022, Medicare will adjust its payment systems to incentivize providers who do good cognitive screening, make timely Alzheimer's diagnoses, and help patients plan their care. This means doctors and health plans that take dementia prevention and early detection seriously will be rewarded financially. Additionally, the bill requires the government to study ways to speed up Alzheimer's research and report back to Congress within a year with recommendations for new policies or laws that could help.

The bill recognizes that Alzheimer's hits certain communities harder—it's more common among African Americans and Hispanics, and affects more women than men. By making early detection routine through Medicare, the bill aims to help catch cases across all populations before symptoms become severe, potentially giving millions of Americans a better chance at managing the disease earlier in its course.

CHANGE Act of 2021

Sánchez, Linda T.

Concentrating on High-value Alzheimer's Needs to Get to an End Act of 2021 or the CHANGE Act of 2021 This bill modifies the requirements under Medicare for diagnosing and treating Alzheimer's disease and other cognitive impairments in older adults. Specifically, the bill expands the cognitive impairment detection benefit during annual wellness visits to require the use of validated detection tools and documentation of the results in the patient's medical record. Further, when a cognitive impairment is detected, the patient must be referred to an appropriate diagnostic service provider and other specified supports. Additionally, the Centers for Medicare &amp; Medicaid Services must implement Medicare policies that increase the identification and response to patients' Alzheimer's disease risk factors and incentivize providers to utilize high-quality cognitive impairment diagnosis practices. The Government Accountability Office also must conduct a study of policies that may accelerate progress in Alzheimer's disease research and enhance the quality of care for individuals diagnosed with Alzheimer's disease.