PCN363 CANCER AND ANNUAL WELLNESS VISITS AMONG OLDER FEMALE MEDICARE BENEFICIARIES

Abstract

Annual Wellness Visit (AWV) for Medicare beneficiaries was introduced by the Affordable Care Act (ACA) to help coordinate screening and preventive care. AWV provides an opportunity to implement comprehensive cancer survivorship plans and improve health outcomes among cancer survivors. Utilization of AWV among women with cancer history is unknown. This study examines the association between cancer history and use of AWV among women (age >66 years) by comparing women with and without a cancer diagnosis. Two retrospective cohorts were identified from the SEER-Medicare linked databases. The cancer cohort (N=64,956) were women diagnosed with breast, cervical, ovarian, or uterine cancer between 2009 and 2011. The non-cancer cohort (N=79,664) was a random 5% sample of female beneficiaries without cancer from the SEER regions. AWV in 2012 were identified using CPT codes. Multivariable logistic regressions were used to analyze the association between cancer history and AWV use. Overall, 8.5% had AWV. Women with cancer had lower rates of AWV (7.4% vs. 9.3%), compared to women without cancer. There was significant association between cancer history and AWV (OR =0.77, 95%CI =0.75, 0.80). Even after adjusting for all the covariates, women with a cancer history were significantly less likely to receive AWV (AOR = 0.71, 95% CI = 0.68, 0.74) compared to those without cancer history. In addition, those aged 66 to 79 years and with comorbidities were more likely to use AWV compared to their counterparts. In this first population-based study, one in 10 older women with a cancer history used AWV. Our study findings highlight the very low-uptake of AWV among older women with and without cancer during the initial years of ACA. Future studies need to explore barriers to AWV and develop targeted interventions to improve AWV rates among women diagnosed with cancer.