Messaging Intervention to Increase Medicare Annual Wellness Visits -- the NUDGE AWV Clinical Trial

Emily Rosenzweig

Status: Active, not recruiting

Conditions: Annual Wellness Visit; Breast Cancer Screening; Colon Cancer Screening

Treatments: Behavioral: Five messaging nudges; Behavioral: Two Messaging Nudges

Study type: Interventional

Funder types: Industry

Identifiers

NCT06640426

RAS20240013

Details and patient eligibility

About

Medicare Annual Wellness Visits (AWVs) are critical for addressing preventive care needs among older adults, yet the most recent estimates from the Center for Medicare Services suggest less than 50% of eligible patients take advantage of this free healthcare benefit. Behavioral science-informed messaging interventions offer a promising strategy to increase AWV participation by guiding patient behavior. In this study, investigators will evaluate a health system initiative that utilizes personalized email and text messages to encourage Medicare beneficiaries to schedule and attend their AWVs. This approach aims to boost patient engagement in preventive health services, ultimately improving care outcomes for older adult populations

Full description

The Centers for Medicare & Medicaid Services (CMS) recommends Annual Wellness Visits (AWVs) to encourage preventive care and improve long-term health outcomes for Medicare beneficiaries. These visits are designed to provide a proactive approach to healthcare by focusing on identifying risk factors, updating medical histories, and developing personalized prevention plans that promote early detection of diseases. By prioritizing prevention over treatment, AWVs help reduce the overall cost burden on the healthcare system while enhancing patient engagement and empowering individuals to take a more active role in managing their health. Yet despite these benefits, most Medicare members who are eligible for an AWV - at no cost to them - do not complete one.

Behavioral science research suggests that personalized messages, designed to facilitate action, can have significant impacts on health behavior. Studies have found these messaging interventions can increase vaccination rates, cancer screening rates, and other care gap closure.

Enrollment: 50,000 estimated patients

Sex: All

Ages: 65+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age 65 or older
• Have either a mobile phone number or an email address on file with the health system
• Included in and non-compliant on the Ascension AWV Clinical Priority Goal measure
• Have consented to receive electronic communications from the health system

Exclusion criteria

• Patients whose primary care providers are exempted from the campaign by the health system
• Completed MAWV appointment in previous 30 days
• Has an upcoming AWV appointment scheduled
• Have received a nudge campaign from the Clinical Transformation team in the past 90 days
• Patients who have previously opted out of receiving electronic communications from the health system in our message delivery platform (Salesforce)

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

50,000 participants in 3 patient groups

Usual Care

No Intervention group

Description:

This is a group will serve as usual care and have no intervention during the study period

Two Messages

Experimental group

Description:

This group will receive two messages as part of the study -- one email and one text message.

Treatment:

Behavioral: Two Messaging Nudges

Up To Five Messages

Experimental group

Description:

This group will receive up to five messages as part o the study -- two emails and three text messages.

Treatment:

Behavioral: Five messaging nudges