Neurology deserts are regions where access to neurological expertise falls short of patient need. Distance, limited specialist availability, and long waits affect patients and the people who care for them.
Attend the Neurology Deserts Webinar
Thursday, November 12, 2026, 1:00 p.m. Eastern / 10:00 a.m. Pacific.
(Recording available to all registrants)
This November 12 webinar will examine the gap in care between specialist visits and the evidence for continuous support, while acknowledging that it cannot replace specialist diagnosis or treatment.
The webinar will draw on published access studies, trials of remote and between-visit care, and Medicare's chronic care management (CCM) requirements. This article previews that evidence, citing the study year with every figure.
Neurologist density varies far more across regions than the prevalence of neurologic conditions does. In an analysis of a 20% sample of 2015 Medicare data, hospital referral regions with the lowest neurologist density had 9.7 neurologists per 100,000 beneficiaries, compared with 43.1 in regions with the highest density, a 4.4-fold difference. Over the same period, the prevalence of neurologic conditions differed by only about 6%, from 293 to 311 per 1,000 beneficiaries (Lin et al., Neurology, 2021). Lin et al., Neurology, 2021
Supply shaped who received care: 23.5% of beneficiaries with a neurologic condition saw a neurologist, from 20.6% in the lowest-supply regions to 27.0% in the highest. The American Academy of Neurology's 2021 workforce report described a mismatch between neurologic care needs and clinician availability in nearly every state. Majersik et al., Neurology, 2021
For most Medicare beneficiaries who saw a neurologist in 2018, the trip was manageable: a median one-way journey of 16.6 miles and 26 minutes. Among the 17% of patients classified as long-distance travelers (a one-way drive of 50 miles or more), median travel distance and drive time rose to 81.3 miles and 90 minutes. Long-distance travel affected 31.8% of patients in the lowest-density regions and 10.8% in the highest, and rural residents had substantially higher odds of a long trip. Lin et al., Neurology, 2023
Waiting is a separate barrier. Among 163,313 beneficiaries who completed a new-patient neurologist visit after referral in 2018 or 2019, the median wait was 34 days, and 18% waited more than 90 days. Waits did not differ between low- and high-density regions, although they varied twofold between states. Lin et al., Neurology, 2025 Those estimates exclude patients who never reached a visit. Among 685,116 Medicare beneficiaries with Parkinson disease in 2019, 40% had no neurologist visit that year. Pearson et al., npj Parkinson's Disease, 2023
For a patient and caregiver, those numbers can mean a day spent on one follow-up visit, a question held for weeks, or an appointment that never happens.
The evidence separates three things that are easy to blur: convenience, patient experience, and demonstrated clinical benefit.
Remote visits deliver convenience. A randomized trial of 195 patients demonstrated high feasibility, with 91% of 388 virtual visits completed, saving a median of 88 minutes and 38 miles of travel per visit. However, virtual visits did not improve quality of life, quality of care, or caregiver burden. Because the cohort was predominantly White (96%), college-educated (73%), and already specialized in care (73%), these convenience benefits may not generalize to underserved populations. (Beck et al., Neurology, 2017). Beck et al., Neurology, 2017
Structured programs show more specific results. The Care Ecosystem trial randomized 780 dementia patient–caregiver pairs to telephone and internet support from trained navigators backed by a specialist team. At 12 months, patient quality of life improved, and emergency department use, caregiver depression, and caregiver burden declined; hospitalizations did not differ significantly. Possin et al., JAMA Internal Medicine, 2019
A CMS-commissioned evaluation linked Chronic Care Management (CCM) to slower growth in Medicare spending, hospitalizations, and emergency use during its first two years. However, this observational spending difference disappeared when beneficiaries who died during follow-up were excluded, with most savings attributed to end-of-life care. Crucially, none of these foundational studies evaluated Advanta's specific services or proprietary clinical models. Mathematica for CMS, 2017
Delegating follow-up does not guarantee better outcomes. A cluster randomized trial of a nurse competency framework in epilepsy found no significant change in seizure severity, and a four-state analysis of 885,132 Medicare beneficiaries with diabetes and other chronic conditions found no significant mortality difference with CCM initiation. Ring et al., Health Technology Assessment, 2018; Ouayogodé and Zheng, Population Health Management, 2026 Clinical impact depends more on what a team does, whom it serves, and how actionable concerns reach clinicians than on how often contact occurs.
Continuous care does not create neurologists. It can address part of what happens between the visits a patient is able to get: a question about an existing plan, a prescription that proved hard to obtain, or an appointment that needs arranging.
At Advanta, care managers are medical assistants who support communication and follow-through. Nurses provide clinical triage. The treating practice makes every diagnosis and treatment decision, and when a concern may be an emergency, care managers direct the patient to call 911.
For eligible Medicare patients, CCM can fund some of that work. Eligibility requires at least two chronic conditions expected to last 12 months or until death and carrying significant risk of death, acute exacerbation, or functional decline, plus consent, an initiating visit where required, a comprehensive care plan, and one billing practitioner per calendar month. CMS CCM guidance A neurological diagnosis alone does not establish eligibility.
A region where neurologist availability falls well below patient need. The term rests on documented variation: in 2015 Medicare data, neurologist density differed 4.4-fold between the lowest- and highest-supply regions while disease prevalence differed by about 6%. Lin et al., 2021
No. Between-visit support can help patients communicate with their care team and follow an existing plan. Diagnosis, treatment decisions, and specialist evaluation remain with the neurologist, and emergencies require emergency services.
No. Medicare CCM requires at least two qualifying chronic conditions and the complete service requirements, including consent and a care plan. CMS eligibility guidance
Advanta Biometrics supports patients between specialist visits through continuous care, with CCM as its current service foundation. Its medical-assistant care managers and nurses work alongside the medical practice, supporting communication while treating professionals retain responsibility for clinical decisions.
Attend the Neurology Deserts Webinar
Thursday, November 12, 2026, 1:00 p.m. Eastern / 10:00 a.m. Pacific.
(Recording available to all registrants)