After Risk-Adjustment Change, Dementia Diagnoses Increased In Medicare Advantage Relative To Traditional Medicare

Health Affairs January 1, 2025
Sidra Haye, Mireille Jacobson, Geoffrey Joyce, Julie M. Zissimopoulos

Abstract

In 2020, the Centers for Medicare and Medicaid Services reintroduced Alzheimer’s disease and related dementias to its risk-adjustment payment model for Medicare Advantage (MA) plans. Using 2017–20 data for 100 percent of community-dwelling beneficiaries enrolled in Medicare, we evaluated how the reintroduction of dementia to the risk-adjustment model affected rates of new (incident) dementia diagnoses among beneficiaries enrolled in MA relative to those enrolled in traditional Medicare. In response to the payment change, annual incident dementia diagnosis rates in MA increased...

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