Standardizing and improving the treatment that Medicare beneficiaries living with dementia receive requires understanding the settings where they are receiving care, the types of clinicians providing that care, and whether clinicians recognize the diagnosis of dementia in their encounters with people living with dementia (PLWD). To investigate these questions, the authors used 100% Medicare fee‐for‐service claims from billing clinicians for all Medicare beneficiaries with dementia in 2019.
Using the 2019 Medicare Carrier file (i.e., where individual clinicians bill for patient care encounters) for all beneficiaries with a recorded dementia diagnosis, over 1.9 million beneficiaries living with dementia received care from 783,225 clinicians. In virtually every setting, the majority of care is delivered by primary care clinicians and nurse practitioners, while psychiatrists, neurologists, and geriatric subspecialists make up a small portion of clinicians delivering care.
This comprehensive analysis of clinician services provided to traditional Medicare beneficiaries with dementia in 2019 reveals the large and diffuse clinical workforce that provides care to these individuals. In addition, the findings underscore the limited number of psychiatry, neurology, and geriatric subspecialty clinicians relative to primary care physicians, nurse practitioners, and physician assistants. Improving the healthcare delivered to PLWD will only be achieved through services that support non‐specialty clinicians across the multiple settings where PLWD receive care.
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