Healthcare provider adoption of cognitive assessment and care planning services associated with uptake among peers

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Abstract
Introduction: In 2017, Medicare introducee Cognitive Assessment and Care Plan (CACP) billing code, which reimburses healthcare providers for comprehensive dementia visits. Uptake of CACP has been very low; drivers of use and underuse are not known. We sought to understand whether CACP spreads through practices after a champion provider adopts CACP. Methods: We used 100% samples of Medicare Fee‐For‐Service claims and Medicare Advantage encounters from 2017 to 2022 to model the relationship between peer CACP adoption and individual CACP adoption. Results: Our sample contained 607,164 providers, 8553 of whom billed for CACP from 2017 to 2022. Having a peer adopt CACP was associated with higher odds of adopting CACP individually (odds ratio [OR]: 17.1, confidence interval 95% CI: 16.1 to 18.2). The association was stronger if the peer shared the same specialty (OR: 23.5, 95% CI: 22.1 to 24.9). Conclusion: Being exposed to a peer who adopted CACP was a strong predictor of providers’ own uptake of CACP.
Funding Information
  • National Institute on Aging (T32AG066576‐01)
  • National Institute on Aging (K23 AG064036)

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