Abstract
The Medicare Current Beneficiary Survey (MCBS) is a large survey utilizing a nationally representative sample of the Medicare population. The MCBS collects data on a whole host of topics including health status, health insurance coverage and financing, access to care, knowledge and understanding of the Medicare Program, as well as use and effectiveness of new program benefits and changes.
Introduction
As part of the Medicare Modernization Act of 2003 and beginning on January 1, 2005, Medicare authorized the coverage of a one-time “Welcome to Medicare” preventative physical exam to occur within the first six months that a beneficiary establishes Part B coverage. This comprehensive exam includes a thorough review of a beneficiary's health, discussion of his/her family history, education and counseling about needed preventative services, such as shots, screening, and/or referrals for other care. The beneficiary's doctor will check his/her blood pressure, weight, and height and where warranted, give or order an electrocardiogram and a simple vision screening test. Beneficiaries are expected to leave their doctor's office with a written plan/checklist of the particular screenings and other preventative services he/she ought to have in the near future.
A New Enrollee Supplement was included within the MCBS beginning in 2006, purposefully created in order to monitor this new benefit that is available to new Medicare Part B enrollees. The Supplement involved the surveying of approximately 1,300 Medicare new enrollees, ages 65-69, in 2006. It will continue to be utilized among the same survey panel of enrollees for the next several rounds of the survey.
A few changes to the “Welcome to Medicare” physical exam benefit have been brought about with the Medicare Improvements for Patients and Providers Act of 2008. Most notably, the Medicare Part B deductible has been waived and new enrollees now have one year from their Part B enrollment date to take advantage of the one-time physical.
Figure 1. “Welcome to Medicare” Physical Exam.
Who Got it and Who Didn't?
- As part of the MCBS New Enrollee Supplement, in the fall of 2005 new beneficiaries were asked whether they'd had the “Welcome to Medicare” physical exam that was offered as part of the “Welcome to Medicare” benefit during their first six months of gaining Medicare Part B coverage.
- Less than 3 percent of the beneficiaries eligible to receive the one-time covered exam took advantage of this benefit.
Figure 2. Medicare Beneficiaries Who Received Their “Welcome to Medicare” Physical Exam.
Reasons for Having the Physical Exam
- The greatest percent, nearly 60 percent, of those reporting having received the “Welcome to Medicare” physical exam, gave as their reason for obtaining the exam that they usually have a routine physical.
Figure 3. Medicare Beneficiaries Who Did Not Receive the “Welcome to Medicare”Physical Exam.
Reasons for Not Receiving the Physical Exam
- Of those surveyed, the main reason for not receiving the “Welcome to Medicare” physical exam was that they did not know about the benefit.
- Less than 1 percent of those surveyed claimed cost as a reason for not participating in the physical exam benefit.
Figure 4. Eligible New Enrollees Who Did Not Receive the “Welcome to Medicare”Physical Exam Due to Their Lack of Knowledge of the Benefit.
If You Had Known About the Physical Examination, Would You Have Had the Physical?
- Respondents who had not received the physical were consequently asked whether they would have received it if they had known about the physical exam benefit. Almost 78 percent attested they would have received the physical if they had known.
Figure 5. Use of the “Welcome to Medicare” Physical Examination 2006 – 2007.
- Looking ahead, Medicare physician claims data from 2006 and 2007 show a slight increase in the utilization of the “Welcome to Medicare” physical exam benefit.
- Follow–up analysis will be needed to see if the changes made to the benefit in 2008 result in increased utilization.
Footnotes
NOTE: Highlights are not peer-reviewed.
The authors are with the Centers for Medicare & Medicaid Services (CMS). The statements expressed in this article are those of the authors and do not necessarily reflect the views or policies of CMS.
Reprint Requests: Cara Petroski and Joseph F. Regan, Centers for Medicare & Medicaid Services, 7500 Security Boulevard, C3-16-27, Baltimore, MD 21244-1850. Internet addresses: cara.petroski@cms.hhs.gov or joseph.regan@cms.hhs.gov