# Project 4 - The Health Impact of Administrative Burdens for People with ADRD

> **NIH NIH P01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2024 · $402,664

## Abstract

OTHER PROJECT INFORMATION – Project Summary/Abstract
Project 4 – The Health Impact of Administrative Burdens for People with ADRD
The lives of people living with Alzheimer’s disease and related dementias are challenging on multiple dimensions
that are made further complicated by healthcare-imposed administrative burdens. People with ADRD struggle
with both complex and simple memory and cognitive tasks that dominate their daily lives, often relying on
overburdened family caregivers. ADRD also face many other, less-obvious challenges related to their health and
well-being, including suffering from a variety of comorbidities, receiving lower quality care when accessing
services to treat these conditions, and high levels of reliance on caregivers for navigating the complexities of the
healthcare system. Further, doctors report challenges treating people with ADRD, including those related to
working with the patient (due to time and communication constraints), those related to billing for services provided
to people with ADRD, and helping them access specialist and social services. These challenges have the
potential to make people with ADRD uniquely impacted by the administrative burdens and hassles imposed by
the U.S. healthcare system. These hassles are pervasive. Patients and healthcare providers encounter these
burdens nearly every time they interact with the system. They come in the form of billing hassles, prior
authorization restrictions, complex applications for public insurance programs, and frequent eligibility
redeterminations for the same programs. Prior work has documented that these burdens and hassles impose
large financial, psychological, and time costs on patients and providers, but they may also affect patient health
and well-being. Hassles associated with accessing care may make providers less willing to treat patients whose
insurers are the most difficult to work with. Hassles associated with enrolling in and remaining enrolled in public
insurance programs may result in incomplete take-up of these programs and high levels of churn in and out of
coverage, possibly causing patients to forgo needed care. In this project, we will study the effects of these
hassles on access to healthcare and health outcomes for people with ADRD. First, we will document the
exposure of people with ADRD to these types of administrative burdens and compare them to those faced by
other patients. Second, we will study burdens in accessing care, focusing on billing hassles and prior
authorization restrictions. Third, we will study burdens in accessing Medicaid (especially long-term services and
supports benefits). Administrative hassles represent another key influence on healthcare delivery, access, and
disparities for people with ADRD and their families, complementing the study of innovative tools, race and
ethnicity, pressured environments, and policy incentives in the other P01 projects.

## Key facts

- **NIH application ID:** 10934401
- **Project number:** 2P01AG005842-35A1
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** Timothy Layton
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $402,664
- **Award type:** 2
- **Project period:** 1997-02-01 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10934401

## Citation

> US National Institutes of Health, RePORTER application 10934401, Project 4 - The Health Impact of Administrative Burdens for People with ADRD (2P01AG005842-35A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10934401. Licensed CC0.

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