Trends in Use of the Cognitive Assessment and Care Planning Services (CAACPS) Visit: A Primary Palliative Care Tool (RP303)

Outcomes 1. Learners will be able to identify gaps in primary palliative care resources for community-living persons with dementia and their caregivers.2. Learners will be able to describe the Cognitive Assessment and Care Planning Services (CAACPS) visit, what it includes, and how it can serve as a primary palliative care tool in the ambulatory care setting. Key Message Older adults diagnosed with Alzheimer's Disease and related dementias (ADRD) experience distressing symptoms, progressive functional incapacity, and ultimately total dependency and death. Nonetheless, the availability of palliative care for persons with dementia outside the acute and skilled care settings is low. The CAACPS visit may address this need. Importance Despite the high symptom and caregiver burden associated with ADRD, the availability of palliative care outside the acute and skilled care settings is low. To address this gap and promote more comprehensive care for community-living PWD, the Cognitive Assessment and Care Planning Services (CAACPS) visit was created in 2017; however, its use has not been reported. Objective(s) The purpose of this study is to describe the provision of Cognitive Assessment and Care Planning Services (CAACPS) visits among community living older adults with ADRD and examine disparities in the receipt of CAACPS visits. Scientific Methods Utilized This study is a secondary analysis using de-identified Optum Clinformatics® Data Mart (CDM) claims data. We evaluated the ambulatory care visits of older adults with an ADRD diagnosis for the years 2018-19. We included patients ≥ 65 years who were alive for at least 3 months of the year and had less than 100 days of residency in a skilled nursing facility (SNF). We excluded visits in acute care, SNFs, and long term care settings. Results For the years 2018-19 only 0.4% and 0.5% of PWD had a CAACPS visit. Those with income $100K and those with college or greater education levels were significantly more likely to receive CAACPS visit. Conclusion(s) Among community-living PWD, few received CAAHPS visits and we identified disparities in visit receipt by income and education. Further research is needed to identify additional patient-level or practice-level factors impacting the delivery CAAPHPS visits. Impact The CAAHPS visit has the potential to be a valuable primary palliative care tool in the ambulatory care setting for community living persons with dementia and their caregivers. Future research to evaluate the impact of CAAHPS visits and promote their use is needed. Keywords Advanced care planning, shared decision making/Palliative care in chronic, non-malignant illness