Practices Caring For Underserved Less Likely to Adopt Medicare’s Annual Wellness Visit

摘要

In 2011, Medicare introduced the Annual Wellness Visit (AWV) – a preventive check-up designed to address health risks in aging adults. For primary care practices, the visit presents an opportunity to generate revenue and may help those within Accountable Care Organizations attract healthier patients and achieve greater stability of patient assignment. However, the AWV has had uneven uptake, likely due in part to complex visit requirements. Using 2008–2015 national Medicare data, we assessed practices’ ability and motivation to adopt AWVs. In 2015, 51.2% of practices provided no AWVs (non-adopting practices) while 23.1% provided them to at least a quarter of their eligible beneficiaries (adopting practices). AWV-adopting practices replaced problem-based visits with AWVs and saw increases in primary care revenue. Compared to non-adopting practices, AWV-adopters had greater stability of patient assignment and slightly healthier patient mix. At the same time, AWV rates were lower among practices caring for underserved populations, potentially worsening disparities.