[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-427278-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-427278-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","home-health-delivery-for-persons-with-dementia-impacts-of-the-new-medicare-payment-system","HOME HEALTH DELIVERY FOR PERSONS WITH DEMENTIA - Impacts of the New Medicare Payment System","","Medicare-funded home health care supports people with dementia (PwD) to meet needs while aging in place, with dementia present in about one-third of patients. In 2020, Medicare introduced the Patient Driven Groupings Model (PDGM), with provisions that reduce reimbursement for home health service types commonly used by PwD. Using linked 2019 and 2021 Medicare home health claims plus patient assessment, geographic, and agency data (n=907,553), the analysis models service types and intensity before versus after PDGM.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/home-health-delivery-for-persons-with-dementia-impacts-of-the-new-medicare-payment-system/427278/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/home-health-delivery-for-persons-with-dementia-impacts-of-the-new-medicare-payment-system/427278.png","ImageObject",300,407,{"name":42,"@type":43},"Emma Wilson","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-20","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What policy change is studied in relation to dementia care at home?","Question",{"text":63,"@type":64},"The study examines the Patient Driven Groupings Model (PDGM) introduced by Medicare in 2020, which affects reimbursement for home health service types used by people with dementia.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How did PDGM affect the likelihood of receiving nursing, therapy, and aide services?",{"text":68,"@type":64},"Compared with the pre-PDGM period, PwD post-PDGM had lower odds of receiving nursing, occupational therapy, social work, and aide services.",{"name":70,"@type":61,"acceptedAnswer":71},"What data and statistical approach were used to evaluate outcomes?",{"text":72,"@type":64},"The analysis uses linked Medicare home health claims from 2019 and 2021, along with patient assessment, geographic, and agency data, applying multivariable logistic and negative binomial regression with extensive adjustments and sensitivity analyses.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},427278,1790801763,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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\nDEMENTIA: IMPACTS OF THE NEW MEDICARE  \nPAYMENT SYSTEM  \nJulia Burgdorf1, and Tracy Mroz2, 1. VNS Health, New York, New York, United States, 2. University of Washington School of Medicine, Seattle, Washington, United States  \nMedicare-funded home health care (HH) is a crucial resource helping Persons with Dementia (PwD) meet their care needs while aging in place. HH includes a mix of skilled nursing, rehabilitation, and personal care services delivered in the patient’s home and one-third of HH patients have dementia. In 2020, Medicare implemented a new HH payment system: the “Patient Driven Groupings Model”(PDGM) . PDGM includes several provisions that effectively reduce reimbursement for the types of HH most used by PwD. Using 2019 and 2021 linked Medicare HH claims, patient assessment, geographic, and HH agency data, we modelled the types and intensity of services received as a function of patient dementia status and year (i.e., pre- or post-PDGM) . Our sample included older adults (65+) receiving community-initiated HH in 2019 or 2021 (n = 907,553) . We modelled outcomes using multivariable logistic and negative binomial regression, adjusting for patient sociodemographic characteristics, functional and clinical status, geographic location, and HH agency characteristics. Compared to pre-PDGM, PwD post-PDGM had lower odds of receiving nursing (Adjusted Odds Ratio (aOR): 0. 73; 95% Confidence Interval (CI):  \n0.72-0.75), occupational therapy (aOR: 0.86; 95% CI:  \n0.84-0. 88), social work (aOR: 0.76; 95% CI: 0.73-0.78), and aide services (aOR: 0.70; 95% CI: 0.68-0.72). Findings persisted following multiple sensitivity analyses, including adjusting for  \n86 Innovation in Aging, 2025, Vol. 9, No. S2  \ncounty-level COVID-19 infection rates. This work presents the first analysis of how HH care delivery shifted for PwD following PDGM; findings suggest unintended consequences that may threaten HH quality and the ability to safely age in place for the high-need population of community-living PwD.","cbCairwKcKo5I4CV","https://ap.wps.com/l/cbCairwKcKo5I4CV","pdf",242588,"English","# Impacts of the New Medicare Payment System\n## Home health care context for people with dementia\n## PDGM reimbursement changes\n## Methods and study sample\n## Main findings on service utilization","[{\"question\":\"What policy change is studied in relation to dementia care at home?\",\"answer\":\"The study examines the Patient Driven Groupings Model (PDGM) introduced by Medicare in 2020, which affects reimbursement for home health service types used by people with dementia.\"},{\"question\":\"How did PDGM affect the likelihood of receiving nursing, therapy, and aide services?\",\"answer\":\"Compared with the pre-PDGM period, PwD post-PDGM had lower odds of receiving nursing, occupational therapy, social work, and aide services.\"},{\"question\":\"What data and statistical approach were used to evaluate outcomes?\",\"answer\":\"The analysis uses linked Medicare home health claims from 2019 and 2021, along with patient assessment, geographic, and agency data, applying multivariable logistic and negative binomial regression with extensive adjustments and sensitivity analyses.\"}]","HOME HEALTH DELIVERY FOR PERSONS WITH DEMENTIA - Impacts of the New Medicare Payment System | PDF",1790643377]