Persistent Disparities in Medicare's Annual Wellness Visit Utilization

Area of Science:

• Public Health
• Health Services Research
• Preventive Medicine

Background:

• The Medicare Annual Wellness Visit (AWV) is a no-cost preventive service established by the Affordable Care Act in 2011.
• AWV is linked to increased utilization of preventive services.
• Previous data indicated lower AWV uptake among ethnoracial minorities.

Purpose of the Study:

• To assess if disparities in AWV utilization by race and ethnicity have continued using recent data.
• To quantify the extent of these disparities in a large Medicare population.

Main Methods:

• Analysis of Medicare Current Beneficiary Survey data from 2011-2013 and 2015-2016.
• Inclusion of a weighted sample of over 78 million fee-for-service Medicare beneficiaries aged 66+.
• Statistical adjustment for potential confounding factors to compare utilization rates across racial and ethnic groups.

Main Results:

• Overall AWV utilization rose from 8.1% in 2011 to 23.0% in 2016.
• Non-Hispanic Black and other race beneficiaries consistently showed significantly lower AWV utilization compared to non-Hispanic whites.
• Hispanic/Latino beneficiaries also had lower utilization, though differences diminished after full adjustment.

Conclusions:

• Despite overall increases, significant ethnoracial disparities in AWV utilization persist among Medicare beneficiaries.
• Addressing these disparities is crucial for maximizing the potential of AWV to improve health and reduce inequities.
• An estimated 1.6 million additional AWVs could have been utilized if minority groups had accessed the service at the same rate as non-Hispanic whites.