The diagnosis and management of patients with dementing illnesses can be challenging, but the cost of misdiagnosing dementia as Alzheimer's disease can be as high as $14,000 a year, according to a study published in Alzheimer's & Dementia.
The diagnosis and management of patients with dementing illnesses can be challenging, but the cost of misdiagnosing dementia as Alzheimer’s disease (AD) can be high, according to a study published in Alzheimer’s & Dementia.
AD is the most common cause of dementia, accounting for 60% to 80% of all dementias in the US, but it is not uncommon for patients with vascular dementia (VD) or Parkinson’s disease (PD) to be misdiagnosed with AD.
The investigators found that approximately 17% of VD patients were misdiagnosed initially with AD and 8% of PD patients had a history of AD misdiagnosis. And for half of the misdiagnosed patients, a correct diagnosis may not be confirmed for more than 1 year.
“The results of this study suggest substantial levels of AD misdiagnosis among Medicare beneficiaries who eventually receive a corrected diagnosis of either VD or PD,” the authors wrote.
They added that their findings suggest there are potential benefits from early and accurate diagnosis. However, they pointed out that the sensitivity of current clinical diagnostic criteria for AD ranges from 71% to 87% and specificity from as low as 44% to 71%. These numbers suggest substantial misdiagnosis rates among patients with dementia.
Excess medical costs for patients misdiagnosed with AD, who were later confirmed to have VD or PD increases annually for each year of misdiagnosis, peaking at approximately $9500 to $14,000 annually.
The researchers used claims data form the Standard Analytical Files for a 5% random sample of Medicare beneficiaries. They separated patients based on the history of AD diagnosis before confirmed VD/PD diagnosis and considered patients with no AD diagnosis before confirmed VD/PD diagnosis as comparators.
“The significant and potentially avoidable medical resource use and related costs associated with misdiagnosis of AD—and their dissipation after the correction of that diagnosis—suggest substantial value not only of ruling out AD but of doing so as early as possible,” the authors concluded.
CMS released a final rule to help patients obtain Children’s Health Insurance Program (CHIP) coverage and issued a proposed rule to update Medicare payment policies and rates for inpatient rehabilitation facilities; debate over if gift card incentives are acceptable in health care marketing.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
A global AIDS program that was in limbo for months got temporary relief after congressional negotiators agreed to a 1-year renewal in the next government funding package; the outcome of the November presidential election could determine the state of fetal tissue research in the US; federal officials and industry executives failed to make improvements that stop hacking attacks.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Fragmented Payer System, Vulnerable Supply Chain Among Threats to Accessing Essential Medicines
March 13th 2024During a session of the 2024 V-BID Summit, panelists Stacie Dusetzina, PhD, and Inma Hernandez, PharmD, PhD, discussed how access to essential medications is curtailed not just by the longstanding complexities of insurance design but also by emerging threats such as supply chain weaknesses and cyberattacks.
Read More
Most private health insurers have yet to publish criteria for when they will cover postpartum depression drug, zuranolone; state lawmakers are increasingly opposing health care mergers that they believe do not serve the public interest; Medicaid extensions made in 2021 led to a 40% decline in postpartum lack of insurance.
Read More