Imagine what a “one-stop shop” practice model could do for patients living with dementia. Rather than a confusing, disjointed continuum of care often linked to unnecessary emergency department visits and poor outcomes, consider a patient-centered medical home that meets patients where they are and provides both memory care and primary care, all in the same place. 

Since 2015, Emory’s Integrated Memory Care Clinic (IMC Clinic) has done just that—and garnered national recognition as a viable model to provide nurse-led primary and dementia care to specialized populations. Indeed, the IMC Clinic is one of the only comprehensive dementia care models across the U.S. that has achieved financial sustainability. Access remains limited, though, as some patients and their caregivers find it difficult to access the clinic, especially in the more advanced stages of the patient’s dementia. 

Reimagining Nursing and Expanding Access to Care 

To increase access to this innovative care, an expanded program—called IMC in Community (IMCiC)—opened in 2022 in the group care settings where these patients typically reside. Initially supported by philanthropic seed funding, the initiative recently garnered concept support, as well as a $1.5 million Reimaging Nursing Initiative grant, from the American Nurses Foundation. The program provides dementia-sensitive primary care within participants’ senior living communities, incorporating occupational therapists and dementia care assistants who help participants maintain independence for as long as possible. The practice works as an integrated team and includes registered nurses, licensed practical nurses, and clinical social workers who support patients and their care partners.

That’s where the business comes in. This year, Goizueta Business School researchers will begin to evaluate the IMCiC program, documenting and quantifying the value of the initiative and assessing its long-term viability as a sustainable business model. Moving forward, the program will follow a subscription-based model, with the aim of being financially self-sustaining. Program support will also rely on direct reimbursement from payers—for example, Medicare and Medicaid—for healthcare services.

Karen Sedatole, the Asa Griggs Candler Professor of Accounting, serves as the evaluation lead for the IMCiC grant.

Healthcare has been in financial crisis for some time. As business leaders and business educators, we must start taking a more active role in solving some of these problems.

Karen Sedatole, Asa Griggs Candler Professor of Accounting

Sedatole says “We can take an active role by helping to document the value that nurses bring to the IMCiC and other new care models, providing the analysis and financial insights to inform how these care models should be structured.” 

Understanding Nurse-Led Transformation 

Alzheimer’s disease, which is the most common cause of dementia among older adults, is the seventh leading cause of death in the U.S., often due to aspiration pneumonia from difficulty with swallowing. As the U.S. population continues to age and the needs become even more dire, care models such as the IMC and IMCiC could play an important part in providing a solution to support this vulnerable population.

“Nurses are the largest workforce in healthcare, yet somehow we’re also the most invisible when it comes to conversations about who is leading change and making a change,” says Carolyn Clevenger, the clinical director of the IMC Clinic and a professor in Emory’s Nell Hodgson Woodruff School of Nursing. 

“This project brings in both the innovation and expertise of nurses and allows them to be visible and out front,” she says.

It also improves the broken financial model and solves multiple problems for a population that needs help. That’s what nurses do – provide real, practical solutions for people today.

Carolyn Clevenger, clinical director, IMC Clinic

Since January 2022, the IMC Clinic and IMCiC have grown from seven to 19 employees who serve hundreds of patients in the greater Atlanta area. Nurses serve as the primary caregivers to these patients. However, the value of nurses is not always recognized. 

“Nurses are often talked about as an expense center–and one of the biggest expenses,” Sedatole says. “In this care model, the IMCiC team is focused on capturing reimbursement driven by nurses and demonstrating that nurses can be a revenue-generating source.”  

Partnering with More Senior Living Communities, Doubling Patients Served 

The IMCiC program is now in active growth mode and adding formal agreements with senior living communities, where nurses and dementia care assistants provide on-site support. The team began the year with one senior living community collaboration and has grown to six agreements, with more to come this summer. They’re also aiming to double the number of patients and families enrolled in the program, with the capacity to add another 500 patients.  

As the program moves into the second year of the three-year grant, team leaders are also beginning to compile consistent data from the project’s initial phase to evaluate important metrics around patient visits, hospitalizations, and financials.

“It’s important to go through this process and demonstrate proof of concept, using financial analyses and documentation of what works and what doesn’t within the business model to show that other practices around the country can do this,” says Ewelina Forker 23PhD, a recently graduated Goizueta PhD student in accounting, who is conducting the program evaluation alongside Sedatole.

To be sustainable, we need real, practical solutions that can help the millions of people who are affected by this nationwide.

Ewelina Forker 23PhD

So far, partners at the senior living communities have voiced major support for the weekly visits—and many have requested twice-weekly visits, either immediately or in the near future. Clevenger has created the fee structure to make this possible in 2023, as well as a staff pipeline to accommodate increasing demands as the program grows. For instance, dementia care assistants are supported with scholarships for nursing school, and they can continue to work part-time as companions to patients in need. 

The research shows that this type of program works for the outcomes that matter, such as keeping patients out of the hospital and de-prescribing high-risk drugs. We can’t do that as effectively unless we take care of patients with primary care and memory care in one location.

Carolyn Clevenger

Clevenger says “what the research hasn’t explained is that the reason we can cover costs is because we’re doing all of the services in one place, and that’s the viability and sustainability we hope to demonstrate with this care model.” 

At Goizueta, we build strategic leaders ready to tackle the complex issues in healthcare through a focus on innovation, strategy, social enterprise, and experiential learning. By leveraging Emory University’s healthcare expertise, Atlanta’s rapidly growing healthcare ecosystem, and our team of world class educators specializing in the business of healthcare, Goizueta positions its graduates to step into strategic careers to create the healthcare of tomorrow. Find out more. 

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It’s all related to The Z Suite, a new exclusive network of Gen Z experts who are voicing their insights and expertise in the retail, consumer, and technology sectors.

“There’s a real need in the industry for a group of Gen Z thought leaders who can speak to brands and retailers about their needs, almost like a think tank,” says Felicia Kane 18BBA, who co-chairs The Z Suite as an account supervisor for Berns Communications Group (BCG).

The specialty PR firm launched The Z Suite in June to add the growing voice of Gen Z consumers to industry networking opportunities and perception studies. The group sits alongside two other networks, the Retail Influencer Network, which includes legacy C-suite brand executives, and The DealmakeHers, which includes female leaders in the retail space. The groups were co-founded by BCG’s president and founder, Stacy Berns.

Legacy players often don’t understand who Gen Z is and why consumers aren’t shopping for their brands. The Z Suite members will act as reverse mentors who can speak about their shared experiences.

Felicia Kane 18BBA

With 27 inaugural members, The Z Suite includes four Goizueta students—Tenzin Gonshar 23BBA, Simran Hussain 21Ox 23BBA, Sash Shaban 20Ox 23BBA, and Natalie Spitzer 23BBA. They have a diverse range of skills in marketing, consulting, and information systems, as well as interests in fashion, music, food, and technology.

I’m looking forward to making connections and giving my authentic input into what brands are doing right now. That type of feedback can be incredibly valuable for companies.

Simran Hussain 21Ox 23BBA

Hussain, who interns for Goizueta, worked for the membership team at adidas during the summer, where she gained insight into consumer behavior, retention, and engagement. As a campus ambassador for Polo Ralph Lauren, she’s also gained experience with corporate social media strategy, content creation, and sales conversions.

“The Z Suite gives a direct line of contact to big companies that have the real impact and power to change a lot within the industry,” she says. “That’s a unique opportunity I wouldn’t have found any other way.”

Bringing Together Gen Z Voices

Kane, who majored in marketing and worked for publications such as Emory’s student-run (404) fashion magazine and Her Campus, long wanted to pair her interests in communications and retail. After working for Bloomingdale’s for two years, she joined BCG, a strategic communications firm focused on thought leadership, corporate brand positioning, and special events management in the retail, fashion, consumer, and technology sectors.

Kane co-chairs The Z-Suite with coworker Carly Berns, as well as a collaborative group of BCG colleagues, including Gabriela Brown 17BBA, who serves as a social media manager for the company and community director for The Z Suite. Brown also majored in marketing, served as an editor for the (404) fashion magazine, and worked at Macy’s in product development for handbags and intimate apparel.

“This is a great way to bring a retail background, consumer experience, and love of storytelling altogether into one,” Brown says. “Gen Z consumers are looking for personalization, convenience, and purposeful shopping.”

The inaugural members of The Z Suite have shared their insights on Gen Z consumer behavior with industry publications and broader news outlets such as Forbes. They’ve emphasized brand values such as sustainability and equity, as well as new avenues to reach Gen Z shoppers through TikTok and Instagram, brand ambassadors, and influencer marketing.

Today’s influencers are different than even two years ago. Anyone can be an ambassador now, and people want to see an authentic voice with the right mix of values, background, and personality.

Gabriela Brown 17BBA

So far, The Z Suite includes students and alumni from Emory, Arizona State University, Cornell University, LIM College, Michigan State University, Northeastern University, New York University, Parsons School of Design, Rensselaer Polytechnic Institute, the University of Chicago, and the University of Pennsylvania. This fall, the group will open its application process to additional colleges and universities, creating a broader pool of experts and voices.

“Gen Z is making sure that brands are standing up for what they’ve spoken about since the summer of 2020, with George Floyd’s death and issues brought to light in a vocal and public way,” Brown says. “They’re going to hold these businesses to account.”

Kicking Off The Big Event

On Sept. 12, BCG’s Retail Influencer Network will host the Retail Influencer CEO Forum, featuring The Z Suite, to provide C-suite retail and brand leaders with a deep understanding of Gen Z’s values, priorities, and shopping behaviors. The invitation-only, half-day summit will feature 20 speakers and take place during New York Fashion Week.

The event will kick off with a conversation about inclusivity with gymnast Aly Raisman and leaders from Aerie and adaptive intimates brand Liberare, moderated by executives at Fast Company and Inc.

Other sessions will cover topics such as Gen Z shopping behavior, sustainability, the metaverse, Web 3.0, Gen Z approaches to beauty and wellness, and how brands can communicate their values and social impact. Speakers from major brands such as American Eagle, Coach, Forever 21, True Religion, and Williams-Sonoma have confirmed their spots on the list.

“With so much out there on social media, it can be hard to have a personal look into how Gen Z perceives companies and their marketing campaigns,” Hussain says. “Since I’m passionate about using consumer responses and sentiment for making future business decisions, I’m excited to be part of a group that will allow companies to do just that.”

Kane and Brown are looking forward to holding regular meetings with members of The Z Suite this fall, as well as breakout sessions and perception studies with major brands. As the group grows, they’ll be able to pursue more thought leadership opportunities, media appearances, and special events.

When I was an intern, I remember having access to brand leaders and hearing their thoughts, which was inspiring. Having The Z Suite members act as reverse mentors will be an invaluable experience, which could shape history from where we are now.

Felicia Kane 18BBA

Hussain also appreciates the Emory ties that run throughout the network, linking up current students as thought leaders, alumni such as Kane and Brown as the coordinators, and legacy brand leaders as voices in the industry.

“The network is vibrant, and it feels heartwarming to know that Emory alumni think about us on campus,” she says. “It builds community and my confidence that, after I graduate, I want to give back and contribute as much as I can.”

Learn more about Marketing faculty research. Gain Marketing faculty insight into “Partnering with a Frenemy” and “The Science of Decision Making.”

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