Days at Home Among Dually Eligible Medicare Beneficiaries With Alzheimer Disease and Related Dementias
-
By
-
Yutong Zhang
-
Yang Yang
-
Johanna Thunell
-
Katherine E. M. Miller
-
July 9, 2026
-
Clinical Scorecard: Home Duration for Medicare and Medicaid Dual Eligibles with Alzheimer’s Disease and Related Dementias
At a Glance
| Category | Detail |
|---|
| Condition | Alzheimer disease and related dementias (ADRD) |
| Key Mechanisms | Access to home- and community-based services (HCBS) and geographic variation in care delivery. |
| Target Population | Older adults (>65 years) who are dually eligible for Medicare and Medicaid. |
| Care Setting | Home and community-based settings. |
Key Highlights
- Over 8 million US older adults are dually eligible for Medicare and Medicaid.
- Mean days at home for older dually eligible PLWD was 238 days in 2021.
- HCBS users had a mean of 275 days at home, indicating the importance of these services.
- Substantial state-level variation in days at home was observed, ranging from 159 to 311 days.
- Factors influencing days at home may include local health service supply and state Medicaid policies.
Guideline-Based Recommendations
Diagnosis
- Utilize CMS Chronic Conditions Data Warehouse (CCW) flags to identify PLWD.
Management
- Ensure access to HCBS to improve days at home for PLWD.
Monitoring & Follow-up
- Track days at home as a key patient-centered outcome measure.
Risks
- Consider potential bias from differential attrition across states due to mortality.
Patient & Prescribing Data
Dually eligible older adults with ADRD.
Access to HCBS is critical for increasing days at home and enhancing quality of life.
Clinical Best Practices
- Promote HCBS utilization among dually eligible PLWD.
- Monitor geographic variations in care to address disparities.
Related Resources & Content
