Dementia care planning can reduce emergency room visits and hospitalizations while improving medication management. But relatively few clinicians are aware of Medicare’s care planning benefit, said Robert Egge, chief public policy officer of the Alzheimer’s Association, during recent testimony before the House Ways and Means Committee.

In 2017, the first year the benefit was available, fewer than 1% of those living with cognitive impairment received care planning, according to a recent study.

Clinicians must play a role in spreading awareness, Egge testified. “For the benefits of care planning to reach more Americans affected by Alzheimer’s, more clinicians must use the care planning benefit,” he said.

To further this goal, the Alzheimer’s Association and other advocates are backing a bill that will increase awareness and utilization of the care planning code (CPT code 99483). 

The bipartisan Improving Hope for Alzheimer’s Act (H.R. 1873/S. 880), introduced this year, would require the Department of Health and Human Services to educate clinicians about the existence and importance of the benefit. It would also require that the department report to Congress on the barriers to receiving care planning services, and ways in which to increase their use. Egge urged the House Committee on Ways and Means to continue pushing the bill forward. 

Medicare care planning involves a clinical care visit that results in a written care plan. The evaluator assesses cognition and function, symptoms, and safety, and identifies a primary caregiver. The benefit also includes the development of an advance care directive and referrals to community services, Egge stated.