ArticleHealth affairs (Project Hope)2022
Evaluating The Accuracy Of Medicare Risk Adjustment For Alzheimer's Disease And Related Dementias.
Article in Health affairs (Project Hope), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- Assigning Probable Dementia Status Using Routinely Collected Electronic Health Record Data.Journal of the American Geriatrics Society · 2026Article
- National trends in the prevalence of dementia in Medicare Advantage and Traditional Medicare.BMC health services research · 2026Article
- Risk Adjustment for Alzheimer Disease and Related Dementias in Medicare Advantage and Health Care Experiences.JAMA network open · 2026Article
- Predicting Mortality and Costs After Emergency Department Visits by People With Dementia: Timing and Location Matter.Journal of the American Geriatrics Society · 2026Article
- Claims-Based Machine Learning Classifier of Modified Rankin Scale in Acute Ischemic Stroke.Journal of the American Heart Association · 2025Article
- Differential dementia detection from multimodal brain images in a real-world dataset.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Evaluating linked ICD-10 Medicare claims data as a method of dementia case ascertainment in research settings.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Incremental Healthcare Costs of Dementia and Cognitive Impairment in Community-Dwelling Older Adults: A Prospective Cohort Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Differences in setting of initial dementia diagnosis among fee-for-service Medicare beneficiaries.Journal of the American Geriatrics Society · 2025Article
- Trends in Incident Dementia Diagnosis Before and After Medicare Risk Adjustment.JAMA network open · 2023Article
- Promise and peril of claims-based dementia ascertainment in causal inference.BMJ evidence-based medicine · 2023Article
- Expected and diagnosed rates of mild cognitive impairment and dementia in the U.S. Medicare population: observational analysis.Alzheimer's research & therapy · 2023Article
- Promising Administrative Measures of Heart Failure and Future Directions.Circulation. Cardiovascular quality and outcomes · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
In 2020 Medicare reintroduced Alzheimer's disease and related dementias (ADRD) Hierarchical Condition Categories (HCCs) to risk-adjust Medicare Advantage and accountable care organization (ACO) payments. The potential for Medicare spending increases from this policy change are not well understood because the baseline accuracy of ADRD HCCs is uncertain. Using linked 2016-18 claims and electronic health record data from a large ACO, we evaluated the accuracy of claims-based ADRD HCCs against a reference standard of clinician-adjudicated disease. An estimated 7.5 percent of beneficiaries had clinician-adjudicated ADRD. Among those with ADRD HCCs, 34 percent did not have clinician-adjudicated disease. The false-negative and false-positive rates were 22.7 percent and 3.2 percent, respectively. Medicare spending for those with false-negative ADRD HCCs exceeded that of true positives by $14,619 per beneficiary. If, after the reintroduction of risk adjustment for ADRD, all false negatives were coded as having ADRD, expenditure benchmarks for beneficiaries with ADRD would increase by 9 percent. Monitoring ADRD coding could become challenging in the setting of concurrent incentives to decrease false-negative rates and increase false-positive rates.
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