Annual Wellness Visits: Usage Rates among Medicare Advantage Enrollees

First in a series of blog posts on annual wellness visits and a new AARP Public Policy Institute study on the topic.

Medicare’s annual wellness visit is a preventive health benefit created by the Patient Protection and Affordable Care Act of 2010. Starting in January 2011, all Medicare beneficiaries with Part B coverage could receive free annual wellness visits 12 months after becoming eligible for Medicare. The purpose of the annual wellness visit, which is not considered a physical examination, is to develop or update a personalized prevention plan and to promote the use of evidence-based preventive health services. (A future blog will discuss more on what such a visit entails.)

Prior research on the annual wellness visit has focused on traditional Medicare and has shown that, in general, beneficiaries are unlikely to use this benefit. However, with Medicare’s private insurance alternative—Medicare Advantage, or MA—now covering about one in every three Medicare beneficiaries nationwide, the need has arisen to understand how health care utilization patterns differ between traditional Medicare and MA enrollees, including concerning annual wellness visit use.

In a recent study, researchers from the AARP Public Policy Institute examined national patterns of annual wellness visit use among MA enrollees. Here are the top-line findings:

MA Enrollees Have Higher Annual Wellness Visit Rates Than Those in Traditional Medicare

One quarter (25.2%) of MA enrollees used the annual wellness visit benefit in 2015—42% higher than the Center for Medicare & Medicaid Services (CMS) estimate for annual wellness visits in the traditional Medicare population. Our finding is important given that CMS does not calculate annual wellness visit usage estimates specifically for MA enrollees and instead reports that “ Medicare Advantage utilization estimates assume the same utilization rate as Medicare Part B.” Also notable is that our finding is consistent with previous research showing higher rates of preventive visits in MA than traditional Medicare.

Rates of Annual Wellness Visits Among MA Enrollees are Increasing

Overall, 6.2% of Medicare Advantage enrollees in our sample had an annual wellness visit in 2011, the first year the benefit was offered. That share quadrupled to 25.2% in 2015, the most recent year of data analyzed.

Annual Wellness Visit Use Varies Substantially by Race and Ethnicity

In each year from 2011 to 2015, annual wellness visit rates for MA enrollees were lowest among Hispanics and highest among Whites. For example, in 2015, 26.3% of White MA enrollees had an annual wellness visit, compared with only 18.3% of Hispanic enrollees.

In future blog posts, we’ll continue to discuss various dimensions of annual wellness visits. We’ll share further details of our study findings and take a step back to discuss facets of annual wellness visits that speak directly to consumers in order for them to better understand the benefit. Next up: what to expect at an annual wellness visit.

Elizabeth Carter is a senior health services research advisor at the AARP Public Policy Institute and an OptumLabs visiting fellow. Her areas of expertise include public health, epidemiology, evidence-based medicine, and low-value services.