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Medicare Spending Spikes for Dementia Diagnoses in Seniors

Medicare spending higher for adults with a formal clinical diagnosis of dementia versus a positive screening for cognitive impairment

MONDAY, June 13, 2022 (HealthDay News) — A diagnosis of Alzheimer disease or related dementia (ADRD) is associated with a large increase in Medicare spending, according to a study published online May 18 in the Journal of the American Geriatrics Society.

Geoffrey J. Hoffman, Ph.D., from the University of Michigan in Ann Arbor, and colleagues used the 1998 to 2018 Health and Retirement Study with linked Medicare claims to assess incremental quarterly spending changes just before versus just after a clinical dementia diagnosis (diagnosis cohort, 2,779) and among 2,318 individuals screened as impaired based on the validated Telephone Interview for Cognitive Status (impairment cohort).

The researchers found that overall spending was $4,773 per quarter, of which 43 percent was spending on hospital care ($2,048). Spending increased by 156 percent, from $5,394 in the quarter prior to diagnosis versus $13,794 in the quarter including the diagnosis. For the group with impairment, adjusted spending did not change from just before to after detection ($2,986 before and $2,962 after). There were no differences observed in incremental spending changes by sex, race, education, dual eligibility, or geography.

“Large, transient spending increases accompany an ADRD diagnosis that may not be attributed to impairment or changes in functional status due to dementia,” the authors write.

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