Alzheimers Dementia: What are the characteristics of dementia-related medical expenditures?

Currently, more than 6 million adults in the United States have Alzheimer's disease and related dementia (ADRD)
.

Current estimates suggest that the cost of ADRD is Medicare (Parts A and B) ranging from $3,019 to $10,598 per person per year (2017 dollars)

Medicaid, the public insurance program for low-income people and the primary payer of long-term care in the U.
S.
, is often overlooked for its costs
.

Because ADRD is characterized by cognitive impairment that results in difficulties with daily activities, the cost of long-term care can be considerable

Four reports estimated the cost of Medicaid nationwide, relying on self-reported usage and imputed Medicaid spending
.

Medicare and Medicaid

Apart from the incompleteness of estimated costs, the literature has largely focused on estimating costs based on prevalent cases
.

Popular cost estimates are useful for understanding current expenditures, but have limited use in predicting future costs if the case mix is ​​changing, or if the cost of the disease changes over the course of the disease

The incidence of ADRD is declining in high-income countries, leading to changes in the case mix, and there is evidence that dementia-related costs vary widely depending on the time since diagnosis or the time before death
.

diagnosis

From this, Norma B.
Coe et al.
of the University of Pennsylvania estimated the incremental cost of ADRD to public finances in the first 5 years after diagnosis through Medicare (Parts A, B, and D) and Medicaid
.

They estimated total spending and spending by cost component (inpatients, prescription drugs, nursing home and home health care, and others) to see which usage was driving costs
.

Using data from the Health and Retirement Study matched to Medicare and Medicaid reimbursement, they identified a retrospective cohort of adults with reimbursement-based ADRD diagnoses, as well as matched controls
.

In the first 5 years after diagnosis, ADRD cost per dementia case was $15,632 and Medicaid was $8,833
.

In the first 5 years after diagnosis, ADRD cost per dementia case was $15,632 and Medicaid was $8,833
.

70% of Medicare costs are incurred in the first two years; Medicaid costs are concentrated on longer-lived beneficiaries who are more likely to need long-term care and be covered by Medicaid
.

Medium implications of this study: Since the distribution of incremental costs varies over time and insurance programs , when an intervention occurs, and how it affects the disease process, will have an impact on how much and which program gets the benefit
.

Because the distribution of incremental costs varies over time and insurance program

Source:
Coe NB, White L, Oney M, Basu A, Larson EB.

Public spending on acute and long‐term care for Alzheimer's disease and related dementias.
Alzheimer's & Dementia.

Public spending on acute and long‐term care for Alzheimer's disease and related dementias.
Alzheimer's & Dementia.
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