Why GAO did this study. The number of Medicare beneficiaries living with a cognitive impairment, such as Alzheimer’s disease, is projected to increase as the American population age 65 and older grows. Such beneficiaries’ health care costs are also projected to increase. CMS began covering the cognitive assessment and care plan services visit in 2017 to increase access to cognitive care services in Medicare. The Consolidated Appropriations Act, 2021, includes a provision for GAO to review use of the cognitive assessment service in the Medicare program. This report describes (1) utilization of the cognitive assessment service in traditional Medicare from 2018 through 2022; (2) stakeholder views on challenges providers face delivering and beneficiaries face accessing the service; and (3) steps CMS has taken to increase awareness of the service. GAO analyzed claims and enrollment data from traditional fee-for-service Medicare from 2018 through 2022 to identify service utilization. GAO interviewed officials representing seven stakeholder groups regarding access and delivery challenges. Organizations included the American Academy of Family Physicians and AARP. GAO also scanned literature to identify research on access challenges; and interviewed agency officials regarding the agency’s outreach campaign. GAO provided a draft of this report to HHS.
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