Research from University of Southern California Reveals New Findings on Dementia (Heterogeneous responses to risk-adjustment reform: evidence from dementia diagnosis in Medicare Advantage): Neurodegenerative Diseases and Conditions – Dementia

2026 AUG 06 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Neurodegenerative Diseases and Conditions - Dementia is the subject of a report. According to news reporting out of Los Angeles, California, by NewsRx editors, research stated, “In 2020, Alzheimer’s disease and related dementias (ADRD) diagnoses were reintroduced into the Medicare Advantage (MA) risk-adjustment model creating financial incentives that may increase diagnostic coding and plan payments. This effect may vary across plans depending on provider integration, administrative capacity, and geographic context, with implications for payments and potential ‘upcoding.’ Methods: Using 100% Medicare data from 2016-2021, we estimated event study and difference-in-differences models comparing adjusted trends in incident ADRD diagnoses in MA relative to traditional Medicare before and after the policy change.”

Funders for this research include National Institute on Aging, National Institute on Aging, National Institute on Aging.

Our news journalists obtained a quote from the research from the University of Southern California, “Incident dementia diagnoses increased in MA relative to traditional Medicare, despite an overall downward trend in diagnosis rates. Increases were larger among enrollees in MA health maintenance organization plans (20.8%) than in preferred provider organization plans (7.6%) and varied across insurers, ranging from 7.2% (United Healthcare) to 21.6% (Kaiser Permanente). Increases were more pronounced in urban than in rural areas. Reintroducing ADRD into the MA risk-adjustment model was associated with increased diagnostic coding, with substantial variation across plan types, insurers, and geographic contexts.”

According to the news editors, the research concluded: “Because ADRD diagnoses increase risk-adjusted payments, larger increases across some plans may reflect coding practices rather than true disease prevalence, highlighting the need for closer monitoring.”

This research has been peer-reviewed.

For more information on this research see: Heterogeneous responses to risk-adjustment reform: evidence from dementia diagnosis in Medicare Advantage. Health Affairs Scholar, 2026;4(7).

Our news journalists report that additional information may be obtained by contacting Mireille Jacobson, Leonard D. Schaeffer Institute for Public Policy & Government Service, University of Southern California, Los Angeles, CA 90089, United States. Additional authors for this research include Sidra Haye and Julie Zissimopoulos.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1093/haschl/qxag167. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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