{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:04:41Z","timestamp":1776229481931,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["AG066605"],"award-info":[{"award-number":["AG066605"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["AG066930"],"award-info":[{"award-number":["AG066930"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living with dementia frequently use Medicare skilled home health care and have unique usage patterns as compared to people without dementia, but little is known about variation in measured quality of home health care received by this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using 2021 Medicare Fee\u2010for\u2010Service Claims data, we examined receipt of high\u2010quality home health (i.e., care from an agency with a star rating &gt;\u20093.5) as determined by two publicly available measures: the Quality of Patient Care Star Rating (based on standardized clinical status measures) and the Patient Survey Star Rating (based on satisfaction with care reported by patients or caregivers). For each quality measure, we mapped the county\u2010level high\u2010quality\u2010home health agency utilization rate among people living with dementia and compared differences in utilization of high\u2010quality home health agencies by dementia status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found significant county\u2010level variability in utilization of high\u2010quality home health. When quality was operationalized based on\n                      <jats:italic>clinical status measures<\/jats:italic>\n                      (i.e., Quality of Patient Care Star Rating), dementia patients did not receive care from lower quality agencies. However, when quality was operationalized based on\n                      <jats:italic>satisfaction with care<\/jats:italic>\n                      (i.e., Patient Survey Star Ratings), people living with dementia were less likely than those without dementia to receive care from high\u2010quality home health agencies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings highlight variability in receipt of high\u2010quality home health care among people living with dementia nationally and suggest a need for further investigation as to what constitutes high\u2010quality home health care in this population. To ensure home health meets the unique care needs of people living with dementia, policy makers should work to ensure quality measures are better aligned with the needs of people living with dementia, incentivize access to high\u2010quality home health care where services are limited, and promote systems to improve family caregiver identification and engagement with home health care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70345","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T04:00:26Z","timestamp":1771819226000},"page":"1080-1088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of Medicare Skilled Home Health for People Living With Dementia in the\n                    <scp>US<\/scp>\n                    : National Patterns and Implications"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8904-8200","authenticated-orcid":false,"given":"Jennifer M.","family":"Reckrey","sequence":"first","affiliation":[{"name":"Division of Geriatric Medicine and Palliative Care, Department of Medicine NYU Grossman School of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9166-693X","authenticated-orcid":false,"given":"Bian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arushi","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Division of Palliative Care and Geriatric Medicine Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1714-7458","authenticated-orcid":false,"given":"Bruce","family":"Leff","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3405-7043","authenticated-orcid":false,"given":"Abraham A.","family":"Brody","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Palliative Care, Department of Medicine NYU Grossman School of Medicine  New York New York USA"},{"name":"NYU Rory Meyers College of Nursing  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3356-1897","authenticated-orcid":false,"given":"Julia G.","family":"Burgdorf","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy and Research VNS Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6270-4423","authenticated-orcid":false,"given":"Katherine A.","family":"Ornstein","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Nursing  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"MedPAC \u201cMedicare Payment Policy Washington DC: Medicare Payment Advisory Comission \u201d2024 https:\/\/www.medpac.gov\/wp\u2010content\/uploads\/2024\/03\/Mar24_MedPAC_Report_To_Congress_SEC\u20103.pdf."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17621"},{"key":"e_1_2_10_4_1","article-title":"Long\u2010Term Care Providers and Services Users in the United States: Data From the National Study of Long\u2010Term Care Providers, 2013\u20132014","volume":"38","author":"Harris\u2010Kojetin L.","year":"2016","journal-title":"Vital and Health Statistics Series 3, Analyses and Surveys"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glv124"},{"key":"e_1_2_10_6_1","unstructured":"Alzheimer's A \u201c2025 Alzheimer's Disease Facts and Figures \u201d2025 https:\/\/www.alz.org\/getmedia\/ef8f48f9\u2010ad36\u201048ea\u201087f9\u2010b74034635c1e\/alzheimers\u2010facts\u2010and\u2010figures.pdf."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igaa049"},{"issue":"3","key":"e_1_2_10_8_1","article-title":"Variation in Home Healthcare Use by Dementia Status Among a National Cohort of Older Adults","volume":"79","author":"Burgdorf J. 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