Project 4 - The Health Impact of Administrative Burdens for People with ADRD

Administrative burdens in healthcare impose large financial, psychological, and time costs, and may also affect patient health and well-being. Due to progressing cognitive limitations and increased reliance on caregivers, people living with Alzheimer's disease and related dementias (ADRD) face a disproportionate burden. This project documents the exposure of people with ADRD to these hassles and uses quasi-experimental methods to study their causal effects on healthcare access and health outcomes. Among the categories of hassles we study are billing hassles, prior authorization restrictions, complex applications for public insurance programs, and eligibility redeterminations for these programs. For example, the hassles associated with accessing care may make providers less willing to treat patients whose insurers are the most difficult to work with. We also study the hassles associated with enrolling in and remaining enrolled in public insurance programs, and the extent to which they result in incomplete take-up, churn in and out of coverage, and access to services, and especially long-term services and supports.