Dementia diagnosis rates 4% lower for Medicare Advantage enrollees
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Key takeaways:
- A study of more than 15 million Medicare beneficiaries assessed dementia diagnosis rates.
- Differences in access to dementia specialists and policy restrictions may explain diagnosis differential rates.
PHILADELPHIA — An analysis of more than 15 million Americans enrolled in Medicare found that those enrolled in the Medicare Advantage plan had a 4% lower dementia diagnosis rate than those in traditional Medicare, according to a presenter.
“The number of individuals with Alzheimer’s disease and related dementias (ADRD) is growing, and as of 2023, 6.7 million Americans are living with ADRD and expected to reach around 30 million by 2060,” Sidra Haye, PhD, postdoctoral research scholar at University of Southern California’s Leonard D. Schaeffer Center for Health Policy & Economics, said during the Alzheimer’s Association International Conference.
Haye and colleague aimed to examine whether dementia diagnosis rates varied for individuals who subscribed to traditional Medicare (TM) or Medicare Advantage (MA) and were seen by the same primary care provider.
Their observational cohort study accessed all Medicare beneficiaries between 2016 and 2018 — including more than 15,000,000 Americans aged 65 or older — enrolled in Medicare Part D and either TM or MA.
The primary outcome was incident dementia verified by a 1-year retrospective measured by the Schaeffer Dementia Algorithm, by tracking PCPs and assigning each Medicare beneficiary to the provider they visited most often.
The researchers utilized propensity score matching to pair TM and MA beneficiaries to a probability of enrolling in MA based on a range of observed characteristics (eg, race, gender, dual eligibility status, education, income chronic health conditions), as well as linear regression.
According to the results, when adjusting for observed differences in patient characteristics and provider selection, dementia diagnosis rates were approximately 4% lower for MA compared with TM.
The researchers observed that roughly 50% of the difference could be attributed to patient characteristics and 25% may be a result of physician selection.
Data further show the mean TM probabilities for differences in actions related to dementia diagnosis were lab testing (92.6%), receiving an Annual Wellness Visit (37.2%), diagnosis by the linked PCP (30.42%), brain imaging (5.53%) and seeing dementia specialists (3.94%).
“Some of these differences might be because of differential access to dementia specialists, also because of restrictions on health care use such as approvals and authorizations,” Haye said. “We are limited by observer statistics that we have in our data, as well as the focus on individuals we assigned PCPs.”