# Applications of Claims-Based Frailty Index to Advance Evidence for Frailty-Guided Decision-Making - Extension to ADRD

> **NIH NIH R01** · HEBREW REHABILITATION CENTER FOR AGED · 2022 · $397,314

## Abstract

PROJECT SUMMARY/ABSTRACT
The Centers for Medicare & Medicaid Services introduced Transitional Care Management (TCM) and Chronic
Care Management (CCM) services to facilitate care management of high-risk patients. While these services can
achieve better health outcomes and reduce health care utilization and costs, they are underutilized due to the
lack of awareness and the resource needs for implementation. Particularly, older adults with Alzheimer's Disease
and Related Dementia (ADRD) require a significant amount of care coordination and account for a large
proportion of ambulatory care sensitive admissions and unplanned readmissions. However, the benefit of TCM
and CCM services in patients with ADRD as a whole and by dementia severity remains unknown. Filling this
knowledge gap can increase adoption of TCM and CCM services for patients with ADRD. The objective of this
supplement to NIA grant R01 AG071809 “Applications of Claims-Based Frailty Index to Advance Evidence for
Frailty-Guided Decision-Making” is to evaluate the effectiveness of TCM and CCM services in improving health
outcomes and reducing health care utilization and costs in older adults with ADRD. The investigators will use
the Medicare 5% random sample data and 2 national surveys of Medicare beneficiaries to test a hypothesis that
TCM and CCM services would be associated with reduced readmission and Medicare costs in older adults with
ADRD. Additionally, the investigators will examine whether a validated claims-based frailty index, which is closely
correlated with functional status and disability, can be a claims-based measure of dementia severity. The specific
aims are 1) to evaluate the effectiveness of Medicare TCM service on 60-day readmission rate and Medicare
costs after acute hospitalization in Medicare beneficiaries with ADRD; 2) to evaluate the effectiveness of
Medicare CCM service on the 1-year home time and health care costs in Medicare beneficiaries with ADRD; and
3) to evaluate whether a claims-based frailty index can be used as a dementia severity measure in Medicare
data by comparing it to dementia severity measures derived from clinical assessment in the Medicare Current
Beneficiary Survey and the National Health and Aging Trends Study. The investigators will then examine whether
the benefit of TCM and CCM services is greater in those with severe dementia than those with mild-to-moderate
dementia. The proposed supplement is expected to have a significant impact on the clinical care and health
services research of ADRD population by promoting uptake of underutilized care management services and
enabling identification of severe dementia from Medicare claims data.

## Key facts

- **NIH application ID:** 10499017
- **Project number:** 3R01AG071809-02S1
- **Recipient organization:** HEBREW REHABILITATION CENTER FOR AGED
- **Principal Investigator:** Dae Hyun Kim
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $397,314
- **Award type:** 3
- **Project period:** 2021-09-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10499017

## Citation

> US National Institutes of Health, RePORTER application 10499017, Applications of Claims-Based Frailty Index to Advance Evidence for Frailty-Guided Decision-Making - Extension to ADRD (3R01AG071809-02S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10499017. Licensed CC0.

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