Objective: To understand health care utilization among Medicare beneficiaries living with Parkinson’s Disease (PD) and how care patterns differ across demographic groups.

Background: Optimal care for the wide-ranging symptoms of PD requires a comprehensive, coordinated care approach delivered by a team that includes general neurologists, movement disorder specialists (MDS), physical and occupational therapists, mental health professionals, and others who have expertise in PD clinical care practices. This research examines clinical utilization patterns for Medicare beneficiaries with PD.

Method: Health care utilization and demographic characteristics of 422,528 people with PD were analyzed using 2019 Medicare fee-for-service claims.

Results: Only 63% of Medicare beneficiaries with PD saw a neurologist for care in 2019, 53% saw a general neurologist and 11% saw a movement disorder specialist (MDS). Annual neurologist visits were lowest among BIPOC[1] individuals (57%) and people living in rural areas (58%), A minority of Medicare beneficiaries with PD used physical therapy (32%), occupational therapy (16%), or speech language pathology services (12%). Utilization of physical therapy was much higher for people who saw an MDS (43%) compared to those seeing a general neurologist (34%). Fewer than 7% of beneficiaries had claims for mental health services, including clinical psychology and psychiatry, though mental health visits may not be paid for with insurance.

Conclusion: Health care utilization among people with PD is low, with many beneficiaries not accessing annual specialist care. Efforts to expand access to and use of specialist care for BIPOC individuals and individuals living in rural areas are important to improve health equity. Patients who see an MDS are also more likely to use other important services, such as physical therapy. Improved clinical education to primary care physicians and general neurologists could support increased use of these services for people living with PD.

References: [1] Advancing Health Equity: A Guide to Language, Narrative, and Concepts. American Medical Association and AAMC Center for Health Justice. Accessed January 26, 2022. https://www.ama-assn.org/system/files/ama-aamc-equity-guide.pdf .

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MDS Abstracts - https://www.mdsabstracts.org/abstract/studying-care-patterns-and-support-preferences-among-people-living-with-parkinsons-disease/