# Person-Reported and Health Care Utilization Outcomes of Home and Community Based Care Recipients With and Without Alzheimer's Disease and its Related Dementias

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2024 · $513,555

## Abstract

Project Abstract:
 More than 5 million Americans live with Alzheimer's disease and related dementias
(AD/ADRD), and they receive care from more than 16 million family caregivers. Providing high
quality care in the community for people with AD/ADRD is a national priority. Persons with
AD/ADRD who are enrolled in Medicaid are eligible to receive home and community-based
services (HCBS). HCBS programs vary by state but in general include supportive services (e.g.,
adult day services and personal care). HCBS are provided by states as an alternative to
institutional care and are believed to promote the clients’ independence, health, well-being and
help avoid or delay more intensive health care utilization (e.g., nursing home admission). But
very little is known about the impact of HCBS for people living with AD/ADRD, including whether
person-reported outcomes differ for those with and without AD/ADRD, and whether person-
reported HCBS outcomes influence use of health care. To determine whether HCBS improve
outcomes that matter to clients, we must first better understand the role of these services from
the perspective of care recipients (i.e., person-reported outcomes).Toward that end, we propose
to use data from the National Core Indicators-Aging and Disabilities (NCI-AD) Adult Consumer
Survey collected between 2017-2020 (n>17,000 HCBS respondents each year), which measure
HCBS quality and service outcomes from clients’ perspectives. We also propose to link NCI-AD
and Medicare and Medicaid claims for respondents in Minnesota (the only state where this
linkage is currently possible) to understand the relationship between person-reported HCBS
outcomes and health care use. In response to RFA AG-20-037 we propose the following
specific aims: 1. Document trends in the HCBS used and/or desired by clients with and
without AD/ADRD. We expect that persons with AD/ADRD will indicate a greater desire to use
more HCBS than they currently receive compared to those without AD/ADRD. 2. Determine
client and state-level factors that promote person-reported HCBS outcomes among
persons with and without AD/ADRD. Hypothesis 2a: Persons with AD/ADRD will have
significantly poorer person-reported HCBS outcomes than persons without AD/ADRD.
Hypothesis 2b: Greater state investment in HCBS relative to institutional care will be associated
with significantly more positive person-reported outcomes for clients both with and without
AD/ADRD. 3. Determine the association between health plan-level HCBS person-reported
quality and health care use (emergency department, hospitalizations, potentially
avoidable hospitalizations, and nursing home admission) for persons with and without
AD/ADRD. Clients who receive HCBS from high quality plans (based on person-reported
outcomes) will use less health care than their counterparts, and this difference will be larger for
clients with AD/ADRD. This study has the potential to yield new evidence both for how HCBS
influence important outcomes for...

## Key facts

- **NIH application ID:** 10758161
- **Project number:** 4R01AG069771-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Eric Jutkowitz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $513,555
- **Award type:** 4N
- **Project period:** 2020-09-30 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10758161

## Citation

> US National Institutes of Health, RePORTER application 10758161, Person-Reported and Health Care Utilization Outcomes of Home and Community Based Care Recipients With and Without Alzheimer's Disease and its Related Dementias (4R01AG069771-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10758161. Licensed CC0.

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