Researchers call for Medicare coverage of driving safety assessments for older and at-risk individuals

In 2020, about 48 million licensed drivers were over the age of 65. Among this age group, motor vehicle crashes resulted in 7,480 deaths and 149,881 nonfatal injuries. Additionally, 17% of people over the age of 65 (about 8.2 million) experience subtle cognitive impairment and are at increased risk for crashes. An correct assessment of driving skills in these individuals cannot be performed in a doctor’s office. Although there are driving safety assessment programs for older adults, these assessments are not covered by Medicare.

Researchers from Brigham and Women’s Hospital, a founding member of the Mass General Brigham health system, examined the current landscape of driving safety assessments and the challenges involved in a paper published in JAMA Neurologycalling on Medicare to cover the cost of a driving safety assessment, which provides health care providers with key information to determine whether a patient is able to drive safely.

Driving is a multi-faceted activity that requires acquired skills and coordination of intricate cognitive and physical functions. As we age, we are susceptible to deterioration of our cognitive, visual, and motor skills, which can impact our ability to drive safely. Therefore, it is imperative that we support programs in our healthcare system that can assess driving safety for at-risk individuals in a manner analogous to Medicare’s coverage of fall risk assessments.

Kirk Daffner, Corresponding Author

Without Medicare support, the financial burden of a comprehensive driving evaluation can be prohibitive. In Massachusetts, for example, a comprehensive driving evaluation costs about $500 to $800 — a significant expense that many MCI drivers and their families may not be able to afford, leaving them without the necessary support and guidance on whether it is unthreatening to continue driving.

In addition, the cost of failing to identify potentially threatening drivers can be significant. Annual Medicare spending on traumatic injuries in 2016 was estimated at more than $16 billion, and motor vehicle accidents were the third leading cause of hospitalizations, emergency room visits, and deaths related to brain injuries.

“The implications of this analysis are significant, go beyond academic discourse, and underscore the need to reconsider the current approach to assessing driving safety,” Daffner added. “Car crashes can be devastating, and impaired drivers pose a safety risk not only to themselves but to the public at enormous. Accurately assessing driver impairment is critical to mitigating harm and improving road safety. It’s time for Medicare to cover driving safety assessment programs.”