Annual wellness visits are associated with increased use of preventive services in patients with diabetes living in the Diabetes Belt

OBJECTIVE: To examine whether Annual Wellness Visits (AWVs) were associated with increased use of preventive services in Medicare patients with diabetes living in the Diabetes Belt. METHODS: We used a case-control design where outcomes were utilization of preventive services recommended for patients with diabetes (foot exam, eye exam, A1c test, and microalbuminuria test) and the exposure was AWVs using data for Medicare patients with diabetes in 2014 − 2015 residing in the Diabetes Belt (N = 412,009). RESULTS: Only 13.4% of patients in 2014 and 17.4% in 2015 used AWVs. Eye exams (61% vs 53%), foot exams (93% vs 79%), A1c tests (81% vs 71%), and microalbuminuria tests (45% vs 28%) were more common among patients who had an AWV in the preceding year compared with those who did not. These differences remained significant after adjusting for patient demographics, comorbidities, county level medical resources, and geographic factors. CONCLUSIONS: AWVs were significantly associated with increased preventive care use among patients with diabetes living in the Diabetes Belt. Low AWV utilization by patients with diabetes in and around the Diabetes Belt is concerning.