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Technology and Dementia Preconference.

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Telehealth significantly increased Annual Wellness Visit (AWV) uptake by 10.2% in traditional Medicare plans, improving access to cognitive screenings for early dementia detection. Further analysis is planned for Medicare Advantage beneficiaries.

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Area of Science:

  • Gerontology
  • Health Services Research
  • Digital Health

Background:

  • Telehealth offers promising solutions for early screening and diagnosis of cognitive impairment and dementia.
  • Digitalized cognitive assessments, like the Montreal Cognitive Assessment (MoCA), can be integrated into Annual Wellness Visits (AWVs).
  • Barriers to telehealth adoption among older adults at risk for Alzheimer's Disease and Related Dementias (ADRD) require investigation.

Purpose of the Study:

  • To evaluate the impact of telehealth on AWV uptake.
  • To determine the influence of telehealth on the modality of AWV completion (in-person vs. telehealth).

Main Methods:

  • A longitudinal cohort of Medicare Advantage (MA) and traditional fee-for-service (FFS) beneficiaries (aged 65+) from 2020-2022 was analyzed.
  • Probit regression models and an instrumental variable (IV) design were employed to assess telehealth adoption's relationship with AWV uptake.
  • Geographic internet connectivity and county-level provider telehealth adoption rates served as IVs to predict telehealth use.

Main Results:

  • Telehealth adopters showed a significant 10.2 percentage point increase in AWV uptake compared to non-adopters in traditional FFS Medicare plans (p <0.001).
  • The study anticipates a more pronounced effect of telehealth on AWV uptake among MA beneficiaries compared to FFS beneficiaries.
  • Potential factors for this difference include MA's enhanced resource allocation for preventative care and internet access.

Conclusions:

  • Telehealth plays a crucial role in increasing AWV uptake and facilitating cognitive assessments.
  • Telehealth can effectively bridge gaps in cognitive screening, enhancing early detection of Mild Cognitive Impairment (MCI) and ADRD.
  • This facilitates timely diagnosis and improves care planning for cognitive decline.