Effects of Medicare wellness visits on health promotion outcomes.

BACKGROUND

The American older adult population has the highest historical prevalence of chronic disease and underuses wellness visit benefits. Little is known about how Medicare wellness visits (MWVs) affect health outcomes.

PURPOSE

The aim of this retrospective case-control study was to examine how MWVs affect health outcomes by measuring two kinds of data for case and control groups at baseline versus 15 months: (1) the differences in blood pressure, fasting lipids, and glucose levels and (2) the completion frequencies for seven screenings and vaccinations.

METHODOLOGY

Informed by Pender's Health Promotion Model, this design used purposively matched samples from a large American Midwestern Medicare population active between January 2013 and January 2016, with a total sample size of 252, consisting of the case group ( N = 120) and control group ( N = 132). The case and control group samples were matched according to gender, age, marital status, Charlson index scores, smoking status, and pharmaceutical classes. The two groups, case (MWV recipients) and matched control (MWV nonrecipients), were compared at different time points using a doubly multivariate repeated-measures analysis procedure. Descriptive statistics were computed to compare completion frequencies between groups.

RESULTS

A doubly repeated multivariate analysis of variance (MANOVA) and descriptive statistics revealed significant differences between the case and control group for three of the four health outcomes. The case group had increased completion frequencies in pneumococcal vaccination.

CONCLUSIONS

Additional research controlling for more variables is warranted to better understand MWV efficacy on health outcomes.

IMPLICATIONS

Primary care providers need to study how MWVs affect longitudinal health outcomes.