# The impact of Medicare managed care on older patients with dementia and their family caregivers.

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $416,678

## Abstract

ABSTRACT
The scope of Alzheimer’s disease and related Dementias (ADRD) in the United States is unprecedented,
affecting 14 million Americans at an annual cost of $200 billion.1,2 Addressing the needs of patients with ADRD
requires substantial long-term behavioral and social care supports not typically available under traditional fee-
for-service insurance. Due to their cognitive limitations, older patients with ADRD may not know that other
potentially beneficial insurance options are available to them. Managed care products may be expected to
improve patient outcomes while restraining health care use. By helping patients, this might also alleviate need
for caregiver support. Thus, managed care might offer critical benefits for ADRD patients and their caregivers.
However, little is known about the role of managed care in dementia care. It is important to understand whether
older individuals with ADRD are using managed care products, which ones they use, and the role of caregivers
in such decisions. It is also important to understand the impact of managed care on health outcomes for older
patients with ADRD including use of informal care. Given the burdens of dementia, and associated impacts on
caregivers, there is a critical need to pursue research to address these knowledge gaps. Using longitudinal
Medicare inpatient data, plus national survey data, the proposed research will use instrumental variables
analysis to explore the impact of managed care on older adults with ADRD including receipt of caregiving.
Innovation: The grant will be the first to rigorously examine the role of managed care programs on outcomes for
a debilitating disease requiring self-management from older adults and their family caregivers. To do so, it will
use a unique and robust mix of survey and claims data to examine managed care and dementia outcomes.
These analyses will be conducted by an interdisciplinary study team with clinical and research expertise in
dementia care, caregiving, and outcomes measurement as well as leaders in policy research. Finally, we have
a robust dissemination strategy exploiting the strengths of our institutional resources for rapid dissemination.
Impact: This project will leverage large national datasets and rare linkages between survey and administrative
data to provide insights for clinicians and policymakers into improving coverage and care strategies for ADRD,
and actionable methods that can support older individuals and their informal caregivers. It will inform insurers
about the extent to which managed care is successful in addressing the needs of the ADRD population and
help patients and caregivers learn select insurance products that are most beneficial for their health.

## Key facts

- **NIH application ID:** 10840456
- **Project number:** 5R01AG074944-03
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** GEOFFREY JONATHAN HOFFMAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $416,678
- **Award type:** 5
- **Project period:** 2022-06-15 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10840456

## Citation

> US National Institutes of Health, RePORTER application 10840456, The impact of Medicare managed care on older patients with dementia and their family caregivers. (5R01AG074944-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10840456. Licensed CC0.

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