Association Of Medicare’s Annual Wellness Visit With Cancer Screening, Referrals, Utilization, And Spending
Open accessAbstract
Medicare's annual wellness visit was introduced in 2011 to promote evidence-based preventive care and identify risk factors and undiagnosed conditions in aging adults. Use of the visit has risen steadily since then, yet its benefits remain unclear. Using national Medicare data for 2008-15, we examined claims from fee-for-service Medicare beneficiaries attributed to practices that did or did not adopt the visit. We performed difference-in-differences analysis to compare differential changes in appropriate and low-value cancer screening, functional and neuropsychiatric care, emergency department visits, hospitalizations, and total spending. Examining 17.8 million beneficiary-years, we found modest differential improvements in rates of evidence-based screening and declines in emergency department visits. However, when we accounted for trends that predated the introduction of the visit, none of these benefits persisted. In sum, we found no substantive association between annual wellness visits and improvements in care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
These sensitivity approaches allow researchers to evaluate robustness of conclusions across reasonable assumptions even without data on potential confounders.
“These approaches allow researchers to evaluate and communicate the robustness of conclusions across reasonable assumptions even lacking data on potential confounders (see examples [104, 105]).”
From Difference-in-Differences for Health Policy and Practice: A Review of Modern Methods (2025) · cites this paper as [104]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Buntin, M., & Zaslavsky, A. (2004) · Journal of Health Economics · doi:10.1016/j.jhealeco.2003.10.005 · Cited by 792 · see citing works
Care Patterns in Medicare and Their Implications for Pay for Performance
Pham, H. H., Schrag, D., O’Malley, A. S., Wu, B., & Bach, P. B. (2007) · New England Journal of Medicine · doi:10.1056/nejmsa063979 · Cited by 513 · see citing works
Effectiveness of Interventions to Increase Screening for Breast, Cervical, and Colorectal Cancers
Sabatino, S. A., Lawrence, B. M., Elder, R. W., Mercer, S. L., Wilson, K. M., DeVinney, B. J., Melillo, S. N., Carvalho, M., Taplin, S. H., Bastani, R., et al. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.04.009 · Cited by 471 · see citing works
Promoting Prevention through the Affordable Care Act
Koh, H. K., & Sebelius, K. G. (2010) · New England Journal of Medicine · doi:10.1056/nejmp1008560 · Cited by 407 · see citing works
The role of primary care in preventing ambulatory care sensitive conditions
Caminal, J. (2004) · European Journal of Public Health · doi:10.1093/eurpub/14.3.246 · Cited by 337 · see citing works
Systematic Review: The Value of the Periodic Health Evaluation
Boulware, L., Marinopoulos, S., Phillips, K. A., Hwang, C. W., Maynor, K. A., Merenstein, D., Wilson, R. F., Barnes, G. J., Bass, E. B., Powe, N. R., et al. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-4-200702200-00008 · Cited by 228 · see citing works
Colorectal cancer screening barriers and facilitators in older persons
Guessous, I., Dash, C., Lapin, P., et al. (2009) · Preventive Medicine · doi:10.1016/j.ypmed.2009.12.005 · Cited by 171 · see citing works
General Health Checks in Adults for Reducing Morbidity and Mortality From Disease
Prochazka, A. V., & Caverly, T. J. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.3187 · Cited by 159 · see citing works
Text Messaging Interventions on Cancer Screening Rates: A Systematic Review
Uy, C., López, J., Trinh‐Shevrin, C., Kwon, S. C., Sherman, S. E., & Liang, P. S. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7893 · Cited by 143 · see citing works
Trends in Use of the US Medicare Annual Wellness Visit, 2011-2014
Ganguli, I., Souza, J., McWilliams, J. M., & Mehrotra, A. (2017) · JAMA · doi:10.1001/jama.2017.4342 · Cited by 107 · see citing works
Self-citationClinical decision support with automated text processing for cervical cancer screening
Wagholikar, K. B., MacLaughlin, K. L., Henry, M. R., Greenes, R. A., Hankey, R. A., Liu, H., & Chaudhry, R. (2012) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-000820 · Cited by 83 · see citing works
General Health Checks in Adults for Reducing Morbidity and Mortality From Disease
Krogsbøll, L. T., Jørgensen, K. J., & Gøtzsche, P. C. (2013) · JAMA · doi:10.1001/jama.2013.5039 · Cited by 73 · see citing works
Improving Value in Health Care — Against the Annual Physical
Mehrotra, A., & Prochazka, A. V. (2015) · New England Journal of Medicine · doi:10.1056/nejmp1507485 · Cited by 72 · see citing works
Self-citationChung, S., Lesser, L. I., Lauderdale, D. S., et al. (2015) · Health Affairs · doi:10.1377/hlthaff.2014.0483 · Cited by 69 · see citing works
Practices Caring For The Underserved Are Less Likely To Adopt Medicare’s Annual Wellness Visit
Ganguli, I., Souza, J., McWilliams, J. M., & Mehrotra, A. (2018) · Health Affairs · doi:10.1377/hlthaff.2017.1130 · Cited by 69 · see citing works
Self-citationThe Annual Physical Examination: Needless Ritual or Necessary Routine?
Laine, C. M. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-136-9-200205070-00013 · Cited by 58 · see citing works
Selection Bias and Nonresponse to Health Promotion in Older Adults
lves, D. G., Traven, N. D., Kuller, L. H., & Schulz, R. (1994) · Epidemiology · doi:10.1097/00001648-199407000-00013 · Cited by 53 · see citing works
Fowler, N. R., Campbell, N. L., Pohl, G. M., Munsie, L. M., Kirson, N. Y., Desai, U. S., Trieschman, E. J., Meiselbach, M. K., Andrews, J. S., & Boustani, M. A. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15330 · Cited by 52 · see citing works
Jensen, G. A., Salloum, R. G., Hu, J., et al. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.03.023 · Cited by 43 · see citing works
Toward Trusting Therapeutic Relationships — In Favor of the Annual Physical
Goroll, A. H. (2015) · New England Journal of Medicine · doi:10.1056/nejmp1508270 · Cited by 36 · see citing works
Ethnoracial Disparities in Medicare Annual Wellness Visit Utilization
Lind, K. E., Hildreth, K. L., Lindrooth, R. C., Crane, L. A., Morrato, E. H., & Perraillon, M. C. (2018) · Medical Care · doi:10.1097/mlr.0000000000000962 · Cited by 36 · see citing works
Ambulatory Care–Sensitive Condition Hospitalizations Among Medicare Beneficiaries
Lin, Y., Eberth, J. M., & Probst, J. C. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.05.005 · Cited by 32 · see citing works
Value of the periodic health evaluation.
Boulware, L. E., Barnes, G. J., Wilson, R. F., et al. (2006) · PubMed · Cited by 26 · see citing works
Galvin, S. L., Grandy, R., Woodall, T., et al. (2017) · North Carolina Medical Journal · doi:10.18043/ncm.78.5.287 · Cited by 26 · see citing works
Reducing Disparities in Healthy Aging Through an Enhanced Medicare Annual Wellness Visit
Tipirneni, R., Ganguli, I., Ayanian, J. Z., & Langa, K. M. (2018) · Public Policy & Aging Report · doi:10.1093/ppar/pry048 · Cited by 19 · see citing works
Self-citationMaking Medicare annual wellness visits work in practice.
Cuenca, A. E. (2013) · PubMed · Cited by 17 · see citing works
Impact of Medicare Annual Wellness Visits on Uptake of Depression Screening
Pfoh, E. R., Mojtabai, R., Bailey, J., Weiner, J. P., & Dy, S. M. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201400524 · Cited by 16 · see citing works
(2018) · arXiv (Cornell University) · Cited by 16 · see citing works
Bowen, M. E., Bhat, D., Fish, J., et al. (2017) · American Journal of Medical Quality · doi:10.1177/1062860617732830 · Cited by 11 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [19]Jones D, Molitor D, Reif J, Baicker K, Bhattacharya J, Deryugina T, What Do Workplace Wellness Programs Do? Evidence from the Illinois Workplace Wellness Study [Internet]. National Bureau of Economic Research Working Paper series Cambridge, MA; 2018 [ cited 2018 Dec 3]. Available from: http://www.nber.org/workplacewellness.
Cited by
Sorted by citations
Difference-in-Differences for Health Policy and Practice: A Review of Modern Methods
Feng, S., Ganguli, I., Lee, Y., Poe, J., Ryan, A., & Bilinski, A. (2025) · Statistics in Medicine · doi:10.1002/sim.70247 · Cited by 16 · see citing works
Self-citationGanguli, I., Lim, C., Daley, N., Cutler, D., Rosenthal, M., & Mehrotra, A. (2025) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.8354 · Cited by 16 · see citing works
Self-citation
- Authors
- Ganguli, I., Souza, J., McWilliams, J. M., & Mehrotra, A.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2019-11-01
- Volume
- 38
- Issue
- 11
- Pages
- 1927-1935
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- PMC
- PMC6903905
- OpenAlex
- W2987865965
- Cited by
- 32
- References
- 29
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 4
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P01AG032952)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- annual wellness visit, Medicare, cancer screening, preventive medicine, low-value care, emergency department visits, hospitalization, health care spending, fee-for-service Medicare, older adults, health policy evaluation
- MeSH terms
- Aged, Emergency Service, Hospital, Health Expenditures, Female, Humans, Insurance Claim Review, Middle Aged, Office Visits, Patient Acceptance of Health Care, Referral and Consultation, United States, Medicare Part A, Medicare Part B, Fee-for-Service Plans, Early Detection of Cancer
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
