Dementia is a leading cause of death in the United States; however, patients dying with this disease may not receive optimal end-of-life care. ... many of these [nursing home] residents commonly experience burdensome and costly interventions, such as hospital transfers, tube-feeding, and intravenous antibiotics. ... Nursing home reimbursement policies are among the factors that incentivize more aggressive care. ... This study linked unique prospective clinical data with Medicare claims to describe and compare patterns of care between nursing home residents with advanced dementia enrolled in a Medicare managed-care insurance plan and those with fee-for-service Medicare.