Association Of Medicare's Annual Wellness Visit With Cancer Screening, Referrals, Utilization, And Spending

Association Of Medicare's Annual Wellness Visit With Cancer Screening, Referrals, Utilization, And Spending
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DOI:
10.1377/hlthaff.2019.00304
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发表时间:
2019-11-01
期刊:
影响因子:
9.7
通讯作者:
Mehrotra, Ateev
Mehrotra, Ateev
中科院分区:
医学1区
文献类型:
--
作者:
Ganguli, Ishani;Souza, Jeffrey;Mehrotra, Ateev

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Medicare's annual wellness visit was introduced in 2011 to promote evidence-based preventive care and identify risk factors and undiagnosed conditions in aging adults. Use of the visit has risen steadily since then, yet its benefits remain unclear. Using national Medicare data for 2008-15, we examined claims from fee-for-service Medicare beneficiaries attributed to practices that did or did not adopt the visit. We performed difference-in-differences analysis to compare differential changes in appropriate and low-value cancer screening, functional and neuropsychiatric care, emergency department visits, hospitalizations, and total spending. Examining 17.8 million beneficiary-years, we found modest differential improvements in rates of evidence-based screening and declines in emergency department visits. However, when we accounted for trends that predated the introduction of the visit, none of these benefits persisted. In sum, we found no substantive association between annual wellness visits and improvements in care.