Medicare Wellness Visits and Cancer Screenings in Rural America

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The Affordable Care Act mandated Medicare coverage of an annual wellness visit, which provides beneficiaries with a free primary care visit that includes a cognitive screening and a personal prevention plan. Policymakers intended these office visits to connect patients with appropriate, routine preventive services, including cancer screenings. However, there has been little research on the effectiveness of the new benefit. This study will examine the effects of Medicare's annual wellness visits in rural America, where people are more likely than those in urban areas to die from cancer, among other conditions, and where rates of early detection for disease are lower. Researchers at the University of Virginia will examine the effectiveness of Medicare's annual wellness visits in increasing the use of preventive care, focusing on receipt of recommended cancer screenings, in rural America. The study's first aim is to examine the effects on use of preventive care by Medicare beneficiaries at the county level; there may be a differential impact on use of preventive screenings, such as those for colorectal, lung, breast, or prostate cancer, compared to nonrural areas. The second aim is to examine the impact of health system resources in adjacent counties on county-level use of preventive care following wellness visits. The project team will analyze 2010-2015 claims data for a random 5 percent sample of Medicare beneficiaries, as well as demographic information from enrollment files. Targeting policymakers, primary care clinicians, and health services researchers, this project will generate evidence about the effects that Medicare's annual wellness visit benefit are having in rural America and suggest areas for future study. If wellness visits are found effective in promoting preventive screening, additional research could identify the sources of disparities in the use of wellness visits and point to interventions to improve access to both wellness visits and follow-up preventive care.

Grant Details

Grantee Organization:
Rector & Visitors of the University of Virginia
Principal Investigator:
Nengliang (Aaron) Yao, Ph.D.
Award Amount:
$153,240.00
Approval Date:
November 14, 2017

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