Healthcare provider adoption of cognitive assessment and care planning services associated with uptake among peers

Introduction In 2017, Medicare introducee Cognitive Assessment and Care Plan (CACP) billing code, which reimburses healthcare providers for comprehensive dementia visits. Uptake of CACP has been very low; drivers of use and underuse are not known. We sought to understand whether CACP spreads through practices after a champion provider adopts CACP. Methods We used 100% samples of Medicare Fee‐For‐Service claims and Medicare Advantage encounters from 2017 to 2022 to model the relationship between peer CACP adoption and individual CACP adoption. Results Our sample contained 607,164 providers, 8553 of whom billed for CACP from 2017 to 2022. Having a peer adopt CACP was associated with higher odds of adopting CACP individually (odds ratio [OR]: 17.1, confidence interval 95% CI: 16.1 to 18.2). The association was stronger if the peer shared the same specialty (OR: 23.5, 95% CI: 22.1 to 24.9). Conclusion Being exposed to a peer who adopted CACP was a strong predictor of providers’ own uptake of CACP.