Insurance type, gender, disability and race of persons with disabilities account for gaps in annual wellness visits

Researchers documented the use of Annual Wellness Visits (AWV) by persons with physical disabilities during the Affordable Care Act rollout. They extracted data from an administrative claims database including both Medicare Advantage and commercial insurance payers from 2008-2016, and looked specifically at unique yearly wellness visits for adults with physical disabilities. They used interrupted time series analysis to compare AWV use by insurance type, gender, disability type and race over time. Results showed that by 2016, AWV reached 47.6 percent (44.7, 50.8) among commercial insurance–covered white women with congenital disabilities (spina bifida and cerebral palsy). In contrast, the rate among commercially insured Hispanic men with acquired disabilities (spinal cord injuries, hemi-, para- and quadriplegia) was lower at 21.6 percent (18.4, 25.2). Medicare Advantage-insured Black and Hispanic men with acquired disabilities had a similarly low level of AWV use. The ACA mandated zero copays, allowing persons with physical disabilities the option for screening without cost. Insurance and gender significantly influenced AWV use, followed by disability type and race. Overall, the highest AWV use for persons with disabilities is nearly 15 percent less than the 62 percent AWV use threshold seen in the general population. Addressing use gaps and increasing AWV use may be one way to increase overall improved health of persons with disabilities.

Annual Wellness Visits for Persons With Physical Disabilities Before and After ACA Implementation

Diane M. Harper, MD, MPH, MS, et al

University of Michigan, Department of Family Medicine, Obstetrics and Gynecology, Ann Arbor, Michigan

https://www.annfammed.org/content/19/6/484