The patient remained at home and hes doing well, and we likely prevented a hospitalization, Hoffmann said. Cognitive Impairment Assessment Making a dementia diagnosis is difficult, and primary care physicians often fail to do so on a timely basis. medical behavioral interview questionsBut new Medicare policies may help change that by specifying what cognitive examinations should entail and offering enhanced payments. Physicians who conduct these evaluations are now expected to meet 10 requirements. In addition to performing a careful physical exam and taking a detailed history, they need to assess an older adults ability to perform activities of daily living, their safety, behavioral and neuropsychiatric symptoms, and caregivers knowledge, needs and abilities. All the medications the senior is taking should be evaluated, and standardized tests used to assess cognition. Efforts to elicit the patients goals and values need to occur in the context of advance planning, and a care plan must be crafted and shared with caregivers. Medicare will pay $238.30 for the initial assessment and additional fees for creating a care plan and performing care management. interview courseHopefully, this will kick start the development of practices that provide these dementia-related services, said Dr. Robert Zorowitz, senior medical director at OptumCare CarePlus, a managed Medicare long-term care program in New York City. Care Between Patient Visits Until now, the rule has been: if the doctor is with a patient, he can bill for his time.
For the original version including any supplementary images or video, visit http://www.seniorjournal.com/NEWS/Medicare/2016/20161223_New_Medicare_Rules.htm
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