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Advance Care Planning Billing Codes Associated With Decreased Healthcare Utilization in Neurological Disease
Brown Gregory, Jesus Sol De, Leboffe Emily, Esch Andy, Newport Kristina. Journal of healthcare management / American College of Healthcare Executives, 2025-01-03
Topic: Risk, prevention and care in population studies
After matching for demographic and health variables, usage of ACP codes was associated with significantly fewer hospitalizations for Alzheimer's disease patients. Across all diseases, there was a 20% to 30% decrease in ED visits, which was significant. Furthermore, there was a significant change in the trend of hospitalizations and ED visits for patients after ACP documentation. ACP billing codes are used infrequently in neurological disease, which may indicate that reimbursement alone is not sufficient to drive code usage. Usage of ACP billing codes was associated with decreased healthcare utilization, particularly in terms of ED visits.
Key findings
- After matching for demographic and health variables, usage of ACP codes was associated with significantly fewer hospitalizations for Alzheimer's disease patients.
- Across all diseases, there was a 20% to 30% decrease in ED visits, which was significant.
- Furthermore, there was a significant change in the trend of hospitalizations and ED visits for patients after ACP documentation.
- ACP billing codes are used infrequently in neurological disease, which may indicate that reimbursement alone is not sufficient to drive code usage.
- Usage of ACP billing codes was associated with decreased healthcare utilization, particularly in terms of ED visits.
Why it matters
This study found that use of advance care planning billing codes was associated with significantly fewer hospitalizations for Alzheimer's disease patients and a 20% to 30% decrease in emergency department visits across all diseases. It concerns healthcare utilization, not treating, curing, or preventing Alzheimer's disease.
Study details
- Study designcohort study
- Effect size1.8%; 3.6%
- Evidence strengthModerate
How this study scored 41/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of healthcare management / American College of Healthcare Executives) |
| Journal's citation record | 0 / 4 | Journal of Healthcare Management: journal h-index 65 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-17) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Kristina Braine Newport: h-index 9 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Pennsylvania State University: institution h-index 1,400 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39748214) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Gregory, B., De, J. S., Emily, L., Andy, E., & Kristina, N. (2025). Advance Care Planning Billing Codes Associated With Decreased Healthcare Utilization in Neurological Disease. Journal of healthcare management / American College of Healthcare Executives. https://doi.org/10.1097/jhm-d-23-00234
Vancouver
Gregory B, De JS, Emily L, Andy E, Kristina N. Advance Care Planning Billing Codes Associated With Decreased Healthcare Utilization in Neurological Disease. Journal of healthcare management / American College of Healthcare Executives. 2025. doi:10.1097/jhm-d-23-00234. PMID: 39748214.
BibTeX
@article{gregory2025-39748214,
author = {Gregory, Brown and De, Jesus Sol and Emily, Leboffe and Andy, Esch and Kristina, Newport},
title = {{Advance Care Planning Billing Codes Associated With Decreased Healthcare Utilization in Neurological Disease}},
journal = {Journal of healthcare management / American College of Healthcare Executives},
year = {2025},
doi = {10.1097/jhm-d-23-00234},
pmid = {39748214},
url = {https://doi.org/10.1097/jhm-d-23-00234}
}
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