Preventive care visits surge, especially among Medicare beneficiaries

Preventive care visits increase: ©Goodluz -stock.adobe.com

A study published in Health Affairs reveals a significant increase in the share of primary care visits focused on preventive care between 2001 and 2019, with the most substantial growth observed among Medicare beneficiaries. The study explores the evolving landscape of preventive care visits and their impact on patient outcomes.

The research, utilizing data from the National Ambulatory Medical Care Survey spanning from 2001 to 2019, analyzed 139,783 primary care physician office visits. Private insurance covered over half of the visits, with Medicare, Medicaid, workers’ compensation, or self-pay accounting for 28.9%. Notably, primary care visits for individuals with Medicare rose from 27.6% in 2001 to 37.7% in 2019.

The percentage of primary care visits with a preventive care focus experienced a noteworthy surge, escalating from 12.8 to 24.6% over the studied period. This upward trend was evident across all age groups and insurance types, with Medicare beneficiaries witnessing the most substantial increase.

This surge translated into a notable rise in the prevalence of preventive visits in the U.S., climbing from 295.9 visits per 1,000 people in 2001 to 463.2 visits per 1,000 people in 2019. Individuals aged 65 and older experienced the most significant increase.

Conversely, the prevalence of problem-based visits declined from 2,017.5 to 1,416.7 visits per 1,000 people over the same period.

The study highlighted that primary care visits centered on preventive care were consistently longer than problem-based visits. Physicians during preventive visits were more inclined to provide counseling related to diet, nutrition, exercise, tobacco, mental health, psychotherapy, or stress management, occurring in 26.5% of preventive visits compared to 24.2% of problem-based visits.

Screening labs were more frequently ordered during preventive visits (33.2%) than problem-based visits (18.4%) between 2018 and 2019. Additionally, preventive images or procedures were more common during preventive visits.

While the growing prevalence of preventive visits could potentially allow more time for physicians to provide evidence-based counseling and preventive services, the study raised concerns about the declining frequency of Americans visiting primary care physicians over time.

The findings suggest an association between insurance designs and the delivery of preventive care. Insurance coverage policies, particularly initiatives like the Affordable Care Act requiring Medicare to fully cover annual preventive exams starting in 2011, are likely contributors to the steeper increases in preventive visits among Medicare beneficiaries.