Older Black and Hispanic Patient Perceptions of Medicare Annual Wellness Visits: A Qualitative Study.

Abstract (English)

PURPOSE: Medicare Annual Wellness Visits (AWVs) offer many potential benefits to older adults, but patients in racial and ethnic minority groups have lower rates of AWV completion. Our objective was to understand older minority patients' attitudes and preferences related to preventive care and AWVs. METHODS: From June 2024 through October 2024, we conducted 4 focus groups at 2 urban primary care settings (ie, an academic health system and a Federally Qualified Health Center) among Medicare enrollees aged 66 years or more with 1 or more primary care encounter at a participating organization during the prior year. We recruited patients with Black race or Hispanic ethnicity documented in the electronic health record. Domains of interest were communication preferences, attitudes about preventive care and AWVs, and barriers to care. Focus groups were audio recorded, and transcripts were coded into key themes using a template analysis approach. RESULTS: There were 45 participants, who had a mean age of 71 years (SD = 4); most were female and identified as Black. Participants reported various forms of preferred communication, including patient portal, phone calls, and mailed letters. Five themes emerged: (1) the value participants placed on their health and preventive care; (2) the value placed on relationships with trusted primary care physicians; (3) barriers to scheduling and attending medical visits; (4) confusion or uncertainty about terminology describing preventive visits in office- and home-based settings, and; (5) lack of trust due to historical discrimination. CONCLUSIONS: Interventions to increase Medicare AWV uptake in Black and Hispanic patients must address and overcome barriers such as those identified in this study.