By RAMI PACKARD and DR. ESTÉE DAVIS

More Americans than ever are suffering from mental and emotional distress. According to a new study published in the journal Psychiatric Services, 3.4 percent of the U.S. population, or more than 8 million Americans, suffer from serious psychological distress (SPD). Just a few of the major challenges we are facing:

• Deaths - over 50,000 deaths occurred from Opioid related addictions in 2016
• Prescription Pain Killers - caused 40 percent of deaths
• Mood Disorders - the third most common cause of hospitalization in the U.S.
• Mental Illness - increasing while insurance coverage and effective treatment declines
• Opioid Addiction - $6 billion is being set aside by the government for treatment

And then there's Alzheimers.

Every senior needs cognitive screening according to the Alzheimers Association. Many patients delay seeking answers to cognitive decline according to a survey included in the Alzheimer's Association's 2019 Alzheimer's Disease Facts and Figures report.

"We need to increase the confidence and the skill of front-line providers so they can provide more care in this area," said Joanne Pike, chief program officer at the Alzheimer's Association.

"And we need to destigmatize the process for seniors, encouraging people to talk to their health care providers and families about their concerns," she said.

In the Alzheimer's Association annual report, they include a call for action to the nation's primary care physicians. Every senior should receive a brief cognitive assessment at their first Medicare annual wellness visit at age 65 and the exams should be a regular part of their ongoing annual care.

Yet a survey by the association found that early cognitive assessments were not the norm during most senior doctor visits.

"The survey found a really troubling underuse of cognitive assessments during the annual healthcare checkup," said Pike. "Despite a strong belief among seniors and physicians that cognitive assessments are important for the early detection of Alzheimer's, only half of the seniors in the survey were being assessed for cognitive decline. And only 16 percent of seniors received regular followup assessments."

A comparison of those statistics against those of other wellness checkup items give a clear picture of the disparity, Pike said. In each visit, physicians check cholesterol 83 percent of the time, vaccinations 80 percent and blood pressure 91 percent of the time, she said.

"So, while physicians say it's important to assess all patients age 65 or older, fewer than half are saying that it's part of their standard protocol," she said.

A good bit of that might be due to "a strong disconnect between seniors and doctors as to who should initiate the conversation," Pike said. Over 90 percent of seniors thought their doctor would recommend testing, so fewer than 1 in 7 brought the topic up on their own, the survey found. Primary care physicians, on the other hand, say they are waiting for senior patients and their families to report symptoms and ask for an assessment.

"We need to increase the confidence and the skills of front-line providers so they can provide more care in this area," Pike said. "And we need to destigmatize the process for seniors, encouraging people to talk to their health-care providers and families about their concerns."

With no significant treatment and no cure in sight, the association's report projects that by 2025, the number of Americans 65 and older with Alzheimer's will "reach 7.1 million - almost a 27 percent increase from the 5.6 million age 65 and older affected in 2019.

It's the "oldest old," those over 85, who are most at risk for Alzheimer's, the association says. In 2019, there are just over 2 million Americans 85 and older; in 2031, when the first wave of baby boomers hits that age, the number will rise to 3 million. By midcentury, there will be 7 million of the "oldest old" in the United States accounting for half of all people over 65 with Alzheimer's.

The cost to society will be substantial, the report says. In 2019 alone, it estimates a $290 billion burden from health care, long-term case and hospice combined. Medicare and Medicaid will cover $195 billion of that, with out-of-pocket costs to caregivers reaching $63 billion.

Cognitive Assessments or Behavioral Health Assessments no longer have to be long paper forms that are confusing for the patient and difficult to score. There are innovative and customizable solutions that even the insurance companies are starting to acknowledge and reimburse those physicians with higher amounts.

These Assessments are for anyone on opioids, at risk of abuse with drugs or alcohol, cognitive decline, PTSD, anxiety disorders, fall risk and so many more.

These automated assessments allow physicians to accomplish two important things:

• Provide improved patient care
• Add additional revenue streams to the practice and yes ... they can be significant!

There are a variety of different screenings to choose from based on your practice and patient's needs. All automated self-screenings are billable from both commercial and government payers.

With the opioid epidemic still hitting the nation strong and mental illness on the rise; by 2030, depression is expected to be the number one disease burden globally; the government is weighing in. As of February 20, 2018, the government has set aside $6 billion for the treatment for patients who suffer from Opioid addiction.

One of the government's solutions for early detection of cognitive decline: Screenings.

If you are currently offering screenings and NOT getting reimbursed as a provider, start getting paid today.

If you are offering the screenings AND getting reimbursed, are there some screening opportunities you are missing for your patients?

In some states, these screenings can substitute for a monthly check in for your patient on opioids and they reimburse significantly higher as their worth is shown to exceed a regular checkup.

The revenue potential can be upwards of $20/screening with NO fees and very little training or additional time needed for you and your staff. If you were to screen just 5 pts/day and each patient took 2 screenings each, that means your practice could bring in an additional $4,000 per month.

Rami Packard is a Regional Developer for RX2Live and assists the growth of medical practices and helps keep their patients well. She also assists with senior and corporate wellness programs. Visit www.rx2live.com/chronic-care-management or contact her at rpackard@rx2live.com

Dr. Estée Davis, PharmD, owns an RX2Live franchise in Melbourne, FL. RX2Live is the only Medical Services Franchise to offer over 18 services for all physician types including specialists and nurse practitioners. She specializes in improving care scores while increasing revenue with NO out of pocket costs to the practice.

To learn more about how your practice can benefit from implementing medically necessary procedures into your daily routine, contact or visit edavis.rx2live.com