Cognitive Assessment At Medicare's Annual Wellness Visit In Fee-For-Service And Medicare Advantage Plans.

The Medicare annual wellness visit-a preventive care visit free to Medicare beneficiaries enrolled in Part B-requires detection of cognitive impairment. We surveyed an internet panel of adults ages sixty-five and older who were enrolled in fee-for-service Medicare or Medicare Advantage to measure the use of that benefit and the receipt of structured cognitive assessment by 2019. Overall, approximately one-half of beneficiaries surveyed reported having an annual wellness visit, and fewer than one-third reported having a structured cognitive assessment. Compared with fee-for-service enrollees, Medicare Advantage enrollees were nearly 20 percentage points more likely to report that they had an annual wellness visit and 8.6 percentage points more likely to report that it included a structured cognitive assessment. The difference suggests that the rate of structured cognitive assessment in fee-for-service Medicare might be increased by offering financial and other incentives for take-up that are similar to those in Medicare Advantage.