Older racial and ethnic minority patients' perceptions of Medicare Annual Wellness Visits: a qualitative study

Although Medicare Annual Wellness Visits (AWVs) offer many potential benefits to older adults, racial and ethnic minorities have lower rates of AWV completion. Our objective was to understand older minority patients' attitudes and preferences related to preventive care and AWVs.

Between June and October 2024, we conducted four focus groups at two urban primary care settings-one academic health system, and one federally qualified health center-among Medicare enrollees aged ≥66 with ≥1 primary care encounter at a participating organization in the prior year. We recruited patients with Black race or Hispanic ethnicity as documented in the electronic health record. Domains of interest were communication preferences, attitudes about preventive care and AWVs, and barriers to care. Focus groups were audio recorded, and transcripts were coded into key themes using a template analysis approach.

There were 45 participants, who had a mean age of 71 years (standard deviation, 4); most were female and identified as Black. Participants reported varying forms of preferred communication, including the patient portal, phone calls, and mailed letters. Five themes emerged: 1) The value placed on participants' health and preventive care; 2) The value placed on relationships with trusted primary care physicians; 3) Barriers to scheduling and attending doctors' visits; 4) Confusion or uncertainty about terminology describing preventive visits, and; 5) Lack of trust due to historical discrimination.

Interventions to increase Medicare AWV uptake in racial and ethnic minority patients must address and overcome barriers such as those identified here.