A new US Government Accountability Office (GAO) report found that the use of cognitive assessment and care plan services tripled in traditional fee-for-service Medicare between 2018 and 2022. However, in 2021, only about 2.4% of traditional Medicare beneficiaries with a diagnosis of Alzheimer’s disease or a related disorder may have received the service.
The report, which published the report on Monday, also revealed that evaluations aren’t being utilized in rural areas as much as urban locations.
CMS started covering the cognitive assessment and care plan services visit in 2017 to increase access to cognitive care services under Medicare. The assessments are available to beneficiaries to evaluate them for cognitive impairments and develop a care plan if the person is diagnosed. A doctor and patient need about 60 minutes face-to-face to complete the evaluation.
However, many providers are only scheduling 15- to 20-minute blocks for the assessments. The evaluation actually takes longer, according to the report; five of the seven groups interviewed said it also takes time before and after the visit to conduct and process the evaluation.
According to the GAO report, uptake may be slow due to stigma, lack of awareness about the service, or because clinicians aren’t devoting enough time to the evaluations as needed. Other challenges still exist so more people can access evaluations, the report showed. Billing limitations prevent some providers from collaborating on the service. Training for primary care doctors is limited as well.
During the time studied (2018 through 2022), providers such as nurse practitioners, neurologists, internists, geriatricians and family doctors delivered more than 80% of the assessments. And most of them were done in urban locations.
The report acknowledged that CMS is working to form and share campaigns to boost awareness that the service exists, and to encourage more older adults to utilize their assessment and care services.
