Reducing Racial and Ethnic Disparities in Medicare Annual Wellness Visit Uptake

Northwestern University

Status: Active, not recruiting

Conditions: Annual Wellness Visit

Treatments: Other: Outreach to encourage Annual Wellness Visit completion

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06996366

STU00219825

R21AG081895-01A1 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The goal of this randomized pilot study is to learn the impact of a primary care outreach intervention on the proportion of patients with Medicare insurance who are up-to-date on Medicare Annual Wellness Visit completion. At two clinics, researchers will randomize clinicians (and their associated, eligible patients) to early or delayed outreach.

Enrollment: 174 patients

Sex: All

Ages: 66+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ≥1 in-person primary care visit during 18-month lookback period AND
• Medicare or Medicare Advantage insurance AND
• ≥1 risk factor shown to be associated with being overdue for Medicare Annual Wellness Visits (identified in preparatory analysis prior to pilot trial): Black/African American race or Latino/Hispanic ethnicity OR Not up-to-date for social needs screening OR Positive social need in past 18 months OR Medicaid insurance OR No use of scheduling features within patient portal in past 18 months
• Preferred language English AND
• Attributed primary care clinic is 1 of the participating clinics in the pilot trial AND
• No AWV completion (CPT G0402, G0438, G0439, G0468) during 10-month lookback period AND
• No appointment scheduled for upcoming AWV

Exclusion criteria

• Patients will be excluded if they are receiving palliative care or if their clinician feels that outreach for preventive care is inappropriate.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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174 participants in 2 patient groups

Early outreach

Experimental group

Description:

Patients assigned to early outreach will receive mailed letter and telephone outreach encouraging them to schedule an Annual Wellness Visit with a primary care clinician. Social determinants of health screening and resource provision if applicable will be included in telephone outreach by health navigator.

Treatment:

Other: Outreach to encourage Annual Wellness Visit completion

Delayed outreach

Other group

Description:

Patients assigned to delayed outreach will receive no outreach for 6 months after study start and then will receive the same outreach intervention as early outreach arm.

Treatment:

Other: Outreach to encourage Annual Wellness Visit completion