Study findings show a minority of healthy Medicare beneficiaries received low-value routine tests during their annual wellness visit (JAMA Netw Open. 2020;3[12]:e2029891. doi:10.1001/jamanetworkopen.2020.29891).
“For healthy adults, routine testing during annual check-ups is considered low value and may trigger cascades of medical services of unclear benefit. It is unknown how often routine tests are performed during Medicare annual wellness visits or whether they are associated with cascades of care,” wrote Ishani Ganguli, MD, MPH, Harvard Medical School, Boston, Massachusetts, and colleagues.
This study aimed to estimate the prevalence of routine electrocardiograms, urinalyses, and thyrotropin tests and tests that might follow among healthy adults receiving Medicare annual wellness visits.
Fee-for-service Medicare claims data from beneficiaries was used to analyze the prevalence of routine tests during annual wellness visits and cascade-attributable event rates. Patient, clinician, and area-level characteristics were also evaluated.
Among the recipients, 18.6% received at least 1 low-value test. Of the tests, 7.2% were electrocardiogram, 10.0% urinalysis, and 8.7% thyrotropin test. Cascade-attributable events and costs were associated with electrocardiograms and urinalyses.
“In this study, 19% of healthy Medicare beneficiaries received routine low-value ECGs, urinalyses, or thyrotropin tests during their [annual wellness visits], more often those who were younger, White, and lived in urban, high-income areas,” concluded Dr Ganguli and colleagues.
“ECGs and urinalyses were associated with cascades of modest but notable cost,” they added.—Lisa Kuhns
