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Provider Adoption of Cognitive Assessment and Care Plan Services and Associated Outcomes for People Living With Dementia
Provider Adoption of Cognitive Assessment and Care Plan Services and Associated Outcomes f...
Provider Adoption of Cognitive Assessment and Care Plan Services and Associated Outcomes for People Living With Dementia

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자료유형  
 학위논문 서양
최종처리일시  
20260202103607
ISBN  
9798286441914
DDC  
614
저자명  
Mulcahy, John.
서명/저자  
Provider Adoption of Cognitive Assessment and Care Plan Services and Associated Outcomes for People Living With Dementia
발행사항  
[Sl] : University of Minnesota, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
95 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-12, Section: B.
주기사항  
Advisor: Neprash, Hannah.
학위논문주기  
Thesis (Ph.D.)--University of Minnesota, 2025.
초록/해제  
요약An estimated 6.7 million people are living with Alzheimer's Disease and Related Dementias (ADRD) in America. ADRD is characterized by declines in cognition, memory, and function over time. Once ADRD has progressed to a severe state, people living with it require high intensity caregiving from family and friends or institutional care. With limited treatment options, ADRD care generally revolves around managing symptoms, long-term care planning, and supporting caregivers. In 2017, the Centers for Medicare and Medicaid (CMS) introduced reimbursement for primary care and other outpatient providers for helping people living with ADRD and their caregivers navigate this process through comprehensive care planning. The specific service is called Cognitive Assessment and Care Planning (CACP) and involves 8 domains of ADRD care and creating a written care plan for the patient. CACP is reimbursed at a higher rate than other office-based interventions to encourage widespread adoption by providers; however, less than 1% of eligible patients received CACP two years after its introduction. In my first chapter I used 100% research identifiable files of both fee-for-service Medicare claims and Medicare Advantage encounters to descriptively investigate trends in CACP receipt/delivery across patient demographics, provider specialties, and visit settings. In my second chapter, I used discrete-time survival modelling to model how awareness of CACP (peer adoption of CACP) and other provider and practice factors impact the odds of providers successfully billing for CACP. In my third chapter, I used two-way fixed effects difference-in-differences modelling to examine the effect of practice CACP adoption on hospitalization and emergency department visits for their patient population. Identifying barriers to provider CACP adoption will help to inform changes that can be made to CACP dissemination efforts and billing requirements to facilitate widespread adoption. Knowing the impact or lack thereof that CACP receipt has on acute healthcare events will help decision makers determine if the current reimbursement rate for CACP is justified, as well as if additional follow-up and support for patients who receive CACP should be incentivized.
일반주제명  
Public health
일반주제명  
Cognitive psychology
키워드  
Cognitive Assessment and Care Planning
키워드  
Healthcare events
키워드  
Dementia
기타저자  
University of Minnesota Health Services Research Policy and Administration
기본자료저록  
Dissertations Abstracts International. 86-12B.
전자적 위치 및 접속  
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MARC

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■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a614
■1001  ▼aMulcahy,  John.
■24510▼aProvider  Adoption  of  Cognitive  Assessment  and  Care  Plan  Services  and  Associated  Outcomes  for  People  Living  With  Dementia
■260    ▼a[Sl]▼bUniversity  of  Minnesota▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a95  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-12,  Section:  B.
■500    ▼aAdvisor:  Neprash,  Hannah.
■5021  ▼aThesis  (Ph.D.)--University  of  Minnesota,  2025.
■520    ▼aAn  estimated  6.7  million  people  are  living  with  Alzheimer's  Disease  and  Related  Dementias  (ADRD)  in  America.  ADRD  is  characterized  by  declines  in  cognition,  memory,  and  function  over  time.  Once  ADRD  has  progressed  to  a  severe  state,  people  living  with  it  require  high  intensity  caregiving  from  family  and  friends  or  institutional  care.  With  limited  treatment  options,  ADRD  care  generally  revolves  around  managing  symptoms,  long-term  care  planning,  and  supporting  caregivers.  In  2017,  the  Centers  for  Medicare  and  Medicaid  (CMS)  introduced  reimbursement  for  primary  care  and  other  outpatient  providers  for  helping  people  living  with  ADRD  and  their  caregivers  navigate  this  process  through  comprehensive  care  planning.  The  specific  service  is  called  Cognitive  Assessment  and  Care  Planning  (CACP)  and  involves  8  domains  of  ADRD  care  and  creating  a  written  care  plan  for  the  patient.  CACP  is  reimbursed  at  a  higher  rate  than  other  office-based  interventions  to  encourage  widespread  adoption  by  providers;  however,  less  than  1%  of  eligible  patients  received  CACP  two  years  after  its  introduction.  In  my  first  chapter  I  used  100%  research  identifiable  files  of  both  fee-for-service  Medicare  claims  and  Medicare  Advantage  encounters  to  descriptively  investigate  trends  in  CACP  receipt/delivery  across  patient  demographics,  provider  specialties,  and  visit  settings.  In  my  second  chapter,  I  used  discrete-time  survival  modelling  to  model  how  awareness  of  CACP  (peer  adoption  of  CACP)  and  other  provider  and  practice  factors  impact  the  odds  of  providers  successfully  billing  for  CACP.  In  my  third  chapter,  I  used  two-way  fixed  effects  difference-in-differences  modelling  to  examine  the  effect  of  practice  CACP  adoption  on  hospitalization  and  emergency  department  visits  for  their  patient  population.  Identifying  barriers  to  provider  CACP  adoption  will  help  to  inform  changes  that  can  be  made  to  CACP  dissemination  efforts  and  billing  requirements  to  facilitate  widespread  adoption.  Knowing  the  impact  or  lack  thereof  that  CACP  receipt  has  on  acute  healthcare  events  will  help  decision  makers  determine  if  the  current  reimbursement  rate  for  CACP  is  justified,  as  well  as  if  additional  follow-up  and  support  for  patients  who  receive  CACP  should  be  incentivized.
■590    ▼aSchool  code:  0130.
■650  4▼aPublic  health
■650  4▼aCognitive  psychology
■653    ▼aCognitive  Assessment  and  Care  Planning  
■653    ▼aHealthcare  events
■653    ▼aDementia
■690    ▼a0573
■690    ▼a0633
■690    ▼a0769
■71020▼aUniversity  of  Minnesota▼bHealth  Services  Research,  Policy  and  Administration.
■7730  ▼tDissertations  Abstracts  International▼g86-12B.
■790    ▼a0130
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357842▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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