Medicare Now Pays Docs To Train Family Caregivers, Why Don’t They?

by Howard Gleckman, for his blog

Starting in 2024, the Centers for Medicare and Medicaid Services began paying doctors and certain other Medicare providers extra money to train and support caregivers. Physicians, nurses, and therapists, for example, can do this work in their offices or in settings such as hospitals or nursing homes prior to a patient’s discharge.

But a new report by AARP and the consulting firm ATI Advisory concludes that while the number of providers taking advantage of the new billing opportunities is slowly growing, overall participation remains vanishingly small.

Little Take-up

There are, depending on who is counting, somewhere between 20 million and 60 million family caregivers in the US. Yet, the report calculated that from the program’s beginning in 2024 through the first half of 2025 (the most recent data available) original Medicare paid about 26,000 caregiver training claims for 9,622 beneficiaries. You read that right: Fewer than 10,000 out of 20 million-plus caregivers received help. Over 18 months.

Medicare also pays providers for completing a health risk assessment of their patients’ caregivers. Curiously, the AARP study found that providers who perform that assessment don’t often follow up with the new training.

Those in Medicare Advantage managed care aren’t much better off. While MA plans are allowed to offer caregiver support as supplemental benefit, the report found only 6% did so.

Impediments

The AARP/ATI authors analyzed Medicare claims data and interviewed providers, advocates, and other stakeholders to find out why participation is so low. They found, not surprisingly, that lack of information about the new billing codes, confusion about the rules, limited training skills, and high start-up costs often were to blame.

How complicated is the billing? Take a look at this flow chart that tries to explain to providers how it works.

While the system makes it complex for doctors and other providers to participate, it is also difficult for patients and their families to navigate. For instance, there is no organized way for them to learn which providers in their communities offer training.

Caregivers desperately need this practical, hands-on coaching. How do you lift a loved one who cannot stand on their own, especially if they outweigh you by 100 pounds? How do you respond to agitation by a family member who is living with dementia?

Meeting these challenges is difficult enough for licensed aides who have formal training. It often is impossible for family members. How can this gap be filled?

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