According to a recent study by the Government Accountability Office (GAO), the use of cognitive assessment and care plan services tripled between 2018 and last year. However, the study also found that very few Medicare beneficiaries who qualify for these services actually received them.
Specifically, the GAO study found that only 2.4% of Medicare beneficiaries diagnosed with Alzheimer’s disease or a related disorder received cognitive assessment and care plan services. The number of Medicare beneficiaries with cognitive impairment is expected to rise as the U.S. population ages.
The Centers for Medicare & Medicaid Services (CMS) began covering cognitive assessments and related care planning in 2017. These services involve a detailed cognitive assessment and the creation of a care plan based on the assessment results for patients showing signs of or diagnosed with cognitive impairment.
The study also revealed that certain providers, such as neurologists, nurse practitioners, internists, family physicians, and geriatricians, delivered over 80% of services, primarily in urban areas.
Providers cited several challenges for the low uptake of these services, including the time required for assessments, billing limitations, and limited training for primary care providers. Additionally, advocacy groups highlighted access challenges stemming from the stigma associated with cognitive impairment and a lack of awareness about these services through Medicare.
The report also pointed to research showing disparities in dementia care among different racial and ethnic groups. Black, Hispanic, and Asian adults have a lower likelihood of receiving a timely diagnosis or comprehensive evaluation compared to white adults.
To address these challenges, CMS and the Department of Health and Human Services (HHS) conducted outreach efforts targeting eligible providers, and added descriptions of the services to the Medicare.gov website and the Medicare and You handbook.
Despite the growing number of Americans dealing with cognitive impairment, concerns are also rising about access to memory care. Supply constraints and financing challenges are making new memory care development difficult, but some senior living operators are considering expanding memory care offerings to accommodate the demographic shifts in the near future.
