Who Provides Home-Based Primary Care to People With Dementia?

Purpose: Home-based primary care (HBPC) for people with dementia is growing. Nurse practitioners (NPs) and physicians (MDs) deliver HBPC, often sharing care. We compared the characteristics of people with dementia receiving HBPC from NPs only, MDs only, and NPs+MDs. Method: The current cross-sectional study used 2019 Medicare claims to identify people with dementia and bivariate statistics to assess differences in patient characteristics (e.g., age, dual-eligibility for Medicare and Medicaid, race/ethnicity, comorbidities) across HBPC provider type. Results: In 2019, 62,094 Medicare beneficiaries with dementia received HBPC. Approximately 40% received HBPC exclusively from NPs, 33% from MDs, and 27% from NPs+MDs. Those seen by NPs+MDs were significantly more racially and ethnically diverse with more comorbidities than those who saw NPs or MDs exclusively. Conclusion: NPs provide HBPC to a sizeable share of homebound people with dementia. Patients cared for by NPs and MDs are more medically and sociodemographically complex than those cared for by a single provider type.