Under the Affordable Care Act (ACA), Medicare introduced a new coverage of annual preventive care visits in 2011, called the Annual Wellness Visit (AWV), which is available at no cost to beneficiaries.

We previously showed a substantial increase in preventive visit use after this ACA policy change among Medicare fee-for-service (FFS) beneficiaries at the Palo Alto Medical Foundation (PAMF).

In this study, we assess the impact of the expanded ACA coverage on the use of preventive visits (Aim 1) and the use of recommended, evidence-based preventive services (Aim 2) among seniors with multiple comorbid conditions (MCCs) as compared to those without MCCs.

We use electronic health records data from the PAMF between 2006 and 2015. The scope of recommended preventive care is not limited to screening for primary prevention, but also includes the prevention of complications due to existing conditions.

Preventive needs can be partly addressed during routine medical visits, but with short appointments there is little time to address both prevention and existing needs. We expect that for seniors with MCCs, the benefits of preventive visits would be amplified, as each of their existing conditions may require unique management and follow-up, but, despite the potential benefits, seniors with MCCs may be less likely to take advantage of the coverage as they are already overwhelmed by frequent medical appointments.

Sascha Dublin, MD, PhD, Group Health Research Institute, serves as consultant. Thomas Gill, MD, Yale School of Medicine, serves as advisor.

PI of the HCSRN-OAIC AGING Initiative is Jerry Gurwitz, MD, Meyers Primary Care Institute.

Funder

National Institute on Aging/HCSRN-OAIC AGING Initiative