Palo Alto Medical Foundation Newsroom

Study Finds More Medicare Seniors Get Preventive Care Since ACA Expansion

The number of eligible seniors enrolled in Medicare fee-for-service who went to their doctor for Annual Wellness Visits increased from 1.4 to 27.5 percent in the three years (2011-2013) since the Affordable Care Act (ACA) expanded Medicare coverage to fully cover preventive care visits, according to a study conducted by Sukyung Chung, Ph.D., assistant scientist at the Palo Alto Medical Foundation Research Institute (PAMFRI) that was published in the January issue of Health Affairs. The study suggests that expanding coverage for Annual Wellness Visits is an effective way of ensuring more seniors get needed preventive care.

The study evaluated primary care patients at the Palo Alto Medical Foundation (PAMF) and assessed the impact of the expansion in coverage on utilization of preventive visits. Among Medicare fee-for-service beneficiaries, annual preventive visit rates increased by two-fold, from 17 percent in 2007 to 32 percent in 2013.

Sukyung Chung, Ph.D.

Sukyung Chung, Ph.D.

“Initially, uptake of Annual Wellness Visits was slow in the first months of new coverage, but ramped up quickly, and by 2013, 32 percent of PAMF patients with traditional Medicare received a preventive visit,” Dr. Chung said. “We anticipate that the rate may continue to rise because the rate for those people is still lower than seniors with private insurance (44 percent) or with Medicare Advantage (52 percent).”

The results of this study suggest that Welcome to Medicare visits and Annual Wellness Visits were used by patients who would not have made a preventive visit without the Medicare coverage expansion. The study shows that relatively straightforward changes in coverage like this can have important and rapid effects on the use of preventive services. Prior to the Medicare’s preventive visit coverage, a physician might try to address preventive and acute or chronic problems during a single non-preventive visit. As coverage for Annual Wellness Visits expanded, preventive issues could be fully addressed in the preventive visit and more chronic issues could be better handled during other problem-focused visits.

“One goal of Healthy People 2020 is a 10 percent increase in the proportion of older adults who receive a core set of preventive services,” Dr. Chung said. “To achieve this goal, providers and patients will have to take full advantage of the Medicare coverage for preventive visits. Our hope is that through education both providers and patients become more aware of available preventive services.”