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Annual wellness visits often a missed opportunity for cognitive assessment

PCPs should make a greater effort to identify Medicare patients who regularly skip annual wellness visits, otherwise they represent a missed opportunity to conduct periodic cognitive assessments, according to data presented at the Alzheimer’s Association International Conference 2016.

The researchers reported that demographic groups with statistically higher rates of dementia — those older than 74 years of age, blacks and Hispanics — were more likely to have Mini-Cog scores consistent with cognitive impairment, but less likely to have had an annual wellness visit.

“The Medicare annual wellness visit can be implemented on a broad scale and sustained over time in health systems, and offers a regular opportunity to establish a baseline measurement and identify changes that may indicate Alzheimer’s or another dementia,” Pamela Mink, PhD, MPH, of Allina Health, in Minneapolis, who presented the data, said in a press release. “Unfortunately, even in our study, the people most vulnerable to dementia are skipping the annual wellness visit, while healthier people show higher usage.”

To determine the uptake and potential impact of annual wellness visits specifically at Allina, a large Midwestern health system, Mink and colleagues drew data from electronic health records of ambulatory patients aged 65 and older. To be included in the study, the patients also had to have at least one outpatient Medicare claim during the previous 21 months, and at least two visits to an Allina primary care clinic during that time.

Data from 105,387 patients, identified from Jan. 1, 2011 to March 1, 2015, were used in the study. Mini-Cog data were available to the researchers beginning in February 2012, with scores of 0 to 2, out of 5, considered positive for cognitive impairment.

According to the researchers, 44.2% of eligible patients had at least one annual wellness visit during the study period, with increases in participation rates occurring with each year — 22.2% in 2011 and 31.1% in 2014. Patients who were female, white or Asian, non-Hispanic, between the ages of 70 and 74, and located in metro regions in the South and East were more likely to have at least one annual wellness visit (all P < .01). Meanwhile, positive Mini-Cog scores (6.1% overall) were more prevalent among patients who were male, black, Hispanic or older than 74 years (all P < .01). – by Jason Laday

Disclosure: Healio Family Medicine could not confirm researchers’ relevant financial disclosures.

Reference:

Mink P, et al. Abstract O2-01-05. Presented at AAIC 2016; July 22-28, 2016; Toronto.