Cognitive evaluation still funnels to specialists who cannot absorb the demand, so patients wait in a referral queue.

Screening tools primary care leans on were built to catch later-stage decline, not the early changes that benefit most from intervention.

Demand climbs as the population ages, widening the gap between who needs evaluation and the capacity to deliver it.

An example of how a multi-state integrated network, redesigned its cognitive pathway across more than 30 teams.

The four criteria they set before choosing a tool, and how they aligned clinical, operational, and finance first.

The tiered, patient-driven screening workflow, delivered natively through Epic and MyChart at the point of care.

Under value-based care, early detection can sharpen risk capture under HCC V28, strengthen Star Ratings, and reduce avoidable admissions.

Under fee-for-service, that same detection supports audit-defensible documentation, billable assessment pathways, and a GUIDE Model entry point.