Dying with dementia in Medicare Advantage, Accountable Care Organizations, or traditional Medicare.

ABSTRACT:

Background/objective

Medicare Advantage (MA) and Accountable Care Organizations (ACOs) operate under incentives to reduce burdensome and costly care at the end of life. We compared end-of-life care for persons with dementia who are in MA, ACOs, or traditional Medicare (TM).

Design, setting, and participants

Retrospective study of decedents with dementia enrolled in MA, attributed to an ACO, or in TM. Decedents had a nursing home stay between 91 and 180 days prior to death, two or more functional impairments, and mild to severe cognitive impairment.

Measurements

Hospitalization, invasive mechanical ventilation (IMV) use, and in-hospital death in the last 30 days of life reported in Medicare billing.

Results

Among 370,094 persons with dementia, 93,801 (25.4%) wer

SUBMITTER: Teno JM 

PROVIDER: S-EPMC8497397 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature