This month, the Alzheimer’s Policy Working Group (APWG) released a new policy paper, Solving America’s Alzheimer’s Challenge, laying out a clinician-driven roadmap to improve how the U.S. diagnoses and manages Alzheimer’s disease—starting in primary care, where most patients first raise concerns.
The paper reflects the real-world experience of frontline physicians from across the country and focuses on practical reforms that can be implemented now to give patients and families more time, more options, and better support.
The Problem: Too Late, Too Often
As the paper explains, many patients who raise memory concerns encounter a system that simply is not built for early detection. Primary care clinicians want to help, but often lack the time, tools, and reimbursement structure needed to conduct cognitive testing during a routine visit. As a result, patients are frequently sent home without answers or placed on long specialist waitlists—missing a critical window for early intervention.
The authors warn that this challenge will only intensify as the population ages. More than one in five Americans over age 65 is already living with undiagnosed mild cognitive impairment, often caused by early-stage Alzheimer’s disease, and clinicians are increasingly seeing younger patients still in the workforce.
What’s Changed—and Why It Matters
The policy paper makes clear that the status quo is no longer defensible because medicine has changed. Brain changes associated with Alzheimer’s can now be detected years—sometimes decades—before severe symptoms appear. According to the report, primary care can play a leading role using tools that already exist, including:
- Validated digital cognitive assessments
- Blood-based biomarker tests
- Team-based care models that guide patients from diagnosis to care planning
Combined with lifestyle interventions such as exercise, nutrition, and management of vascular risk factors, earlier diagnosis can preserve independence and quality of life for many patients.
Key Recommendations
The Alzheimer’s Policy Working Group outlines several actionable recommendations, including:
- Encouraging early lifestyle interventions at the first signs of cognitive impairment to help preserve and even improve cognitive function
- Modernizing billing and reimbursement, including clearer guidance and new codes to support digital cognitive assessments and team-based care in primary care settings
- Expanding the clinical workforce by enabling nurse practitioners and physician assistants to receive specialized training and certification in Alzheimer’s diagnosis and management
- Aligning health system incentives so administrators understand the full value of Alzheimer’s care pathways, rather than treating diagnosis and treatment as disconnected services
Proof That It Works
Importantly, the report does not rely on theory alone. It highlights real-world models from institutions such as the University of Kansas, the University of Washington, Indiana University, and Wake Forest, where redesigned care pathways dramatically increased early diagnoses, cut wait times from months to days, and expanded access—often without adding neurologists or sacrificing quality.
Market Institute’s Take
At the Market Institute, we believe Alzheimer’s policy should focus on empowering clinicians and patients—not layering on new mandates or bureaucracy. This paper makes a strong case that smarter incentives, better tools, and clearer pathways can deliver earlier diagnoses and better care while making the system more sustainable.
The Alzheimer’s Policy Working Group’s recommendations deserve serious attention from policymakers, health systems, and payers looking for solutions that actually work in practice.
Read the full policy paper here:
👉 alzpolicy.org
Market Institute will continue to highlight policy ideas that improve patient outcomes, strengthen primary care, and encourage innovation in healthcare delivery.
