Estimates of diagnosed dementia prevalence and incidence among diverse beneficiaries in Traditional Medicare and Medicare Advantage

Abstract

AbstractBackgroundApproximately half of Medicare beneficiaries are enrolled in Medicare Advantage (MA) ‐ a private plan alternative to Traditional Medicare (TM). Yet little is known about diagnosed dementia rates among Medicare Advantage enrollees, limiting population estimates.Methods100% claims of Medicare beneficiaries using Encounter data for MA and claims for TM were used to quantify diagnosed dementia prevalence and incidence rates in MA, compare rates to TM, and provide estimates for the entire Medicare population and for different racial/ethnic populations.ResultDementia incidence and prevalence among MA beneficiaries was 2.54% (95%CI 2.53‐2.55) and 7.04% (95%CI 7.03‐7.06). Comparison to TM adjusted for sociodemographic and health differences among beneficiaries in MA and TM; the prevalence of diagnosed dementia among beneficiaries in MA was lower (7.1%; 95%CI 7.12‐7.13) than in TM (8.7%; 95%CI 8.71‐8.72). Diagnosed dementia incidence rate was also lower in MA (2.50%; 95%CI 2.50‐2.50) compared to TM (2.99%; 95%CI 2.99‐2.99). There were lower rates in MA compared to TM for men and women and White, Black, Hispanic, Asian, American Indian/Alaska Native persons. Diagnosed dementia prevalence and incidence for the entire Medicare population was 7.9% (95%CI: 7.91‐7.93) and 2.8% (95%CI: 2.77‐2.78).ConclusionLower diagnosed dementia rates in MA compared to TM may exacerbate racial/ethnic disparities in diagnosed dementia. Rates tracked over time will provide understanding of impact on dementia diagnosis of 2020 MA risk adjustment for dementia.