Jacobson Mireille, Thunell Johanna, Zissimopoulos Julie
Mireille Jacobson (
Johanna Thunell is a postdoctoral research fellow in the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California.
Health Aff (Millwood). 2020 Nov;39(11):1935-1942. doi: 10.1377/hlthaff.2019.01795.
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.
医疗保险年度健康检查——一项面向参加B部分的医疗保险受益人的免费预防性保健检查——需要检测认知障碍。我们对一个由65岁及以上参加按服务收费医疗保险或医疗保险优势计划的成年人组成的互联网小组进行了调查，以衡量该福利的使用情况以及截至2019年接受结构化认知评估的情况。总体而言，约一半接受调查的受益人报告称进行了年度健康检查，不到三分之一的人报告称接受了结构化认知评估。与按服务收费的参保人相比，医疗保险优势计划的参保人报告进行年度健康检查的可能性高出近20个百分点，报告检查包括结构化认知评估的可能性高出8.6个百分点。这种差异表明，通过提供类似于医疗保险优势计划的经济和其他激励措施来促进参保，按服务收费的医疗保险中结构化认知评估的比例可能会提高。
