Researchers are asking Medicare to cover driving safety assessments for at-risk older adults

In 2020, approximately 48 million licensed drivers were over 65 years of age. In this age group, traffic accidents resulted in 7,480 deaths and 149,881 non-fatal injuries. Additionally, 17% of people over 65 (about 8.2 million) have mild cognitive impairment and are at increased risk of accidents. Accurate assessment of driving skills in these individuals cannot be done in the doctor’s office. While there are existing driver safety assessment programs for seniors, these assessments are not covered by Medicare.

Researchers from Brigham and Women’s Hospital, a founding member of the Mass General Brigham Health Care System, analyzed the current landscape of driving safety assessments and related challenges in an opinion piece published in JAMA Neurologyrequiring Medicare to cover driving safety assessments that will equip healthcare professionals with critical information to determine whether a patient is capable of driving safely.

Driving is a multifaceted activity that requires skill knowledge and coordination of complex cognitive and physical functions. As we age, we are vulnerable to declines in our cognitive, visual and motor skills that can affect our ability to drive safely. Therefore, it is imperative that we support programs in our health care system that can assess the driving safety of at-risk individuals in a manner analogous to Medicare’s coverage of fall risk assessment.”

Kirk Daffner, corresponding author

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

Furthermore, the cost of not recognizing potentially dangerous drivers can be significant. Annual Medicare spending on traumatic injuries in 2016 was estimated at more than $16 billion, and traffic accidents were the third leading cause of hospitalizations, emergency room visits, and deaths related to traumatic brain injuries.

“The implications of this analysis are significant, extend beyond the academic debate, and highlight the need to rethink the current approach to assessing driving safety,” added Daffner. “Motor vehicle crashes can be devastating, and impaired drivers pose safety risks not only to themselves, but to the public at large. Accurate assessment of driving ability is critical to mitigating harm and improving of road safety. It’s time for Medicare to cover driver safety assessment programs.”