IADL criteria include almost the entire sample. ADL eligibility criteria leave out people with relatively severe dementia and with behavioral problems which potentially pose health or safety risks. It is important to consider behavioral and mental status test criteria in establishing eligibility for community-based services for people with dementia. Patrick Fox, Ph.D. Applicants were randomized either into a group with a limited Medicare community care service benefit and case management or into a control group receiving their regular medical care. The program was not expressly targeted to work with health care providers.
Analyses assess whether community care management affected health care use.
A tendency toward reduced expenditures was observed for the treatment group, combining all demonstration sites, and when observing each separately. Expenditure reductions approached budget neutrality with program costs in two sites. Cost and Outcomes of Medicare Reimbursement for HMO Preventive Services Donald L. Patrick, Ph.D., M.S.P.H., David Grembowski, Ph.D., Mary Durham, Ph.D., Shirley A.A. Beresford, Ph.D., Paula Diehr, Ph.D., Jenifer Ehreth, Ph.D., Julia Hecht, Ph.D., M.P.H., Joe Picciano, and William Beery, M.P.H. Medicare beneficiaries enrolled in an HMO were randomized to a preventive services benefit package for two years, or usual care. At 24 and 48 month follow-ups, the treatment group had completed more advance directives, participated in more exercise, and consumed less dietary fat than the control group. Unexpectedly, more deaths occurred in the treatment group.