Mental Health Referrals Among Medicare Advantage Enrollees Receiving Home-Based Annual Wellness Visits in Puerto Rico During the COVID-19 Pandemic

Annual Wellness Visits (AWV) promote preventive care for older adults, yet uptake remains low. To increase AWVs, a Medicare Advantage (MA) plan in Puerto Rico contracted a medical group to provide home-based AWVs during the last quarter of 2020. Using data from 464 visits, we conducted descriptive and multivariable analysis to profile patient characteristics and identify predictors of mental health referrals. We found that 87% of patients had multiple chronic conditions, 75% were taking more than 5 medications, and the odds of a mental health referral were higher for those who also had a nutrition-related condition (AOR = 5.05, CI95: 1.76-11.88), diabetes (AOR = 3.34, CI95: 1.18-7.58), or an additional reported uncontrolled health issue (AOR = 28.18, CI95: 8.96-70.59). This strategy helped one MA plan reach high-need patients, but coordination of follow-up care is needed to ensure patients receive recommended services.

Automated summary

Annual Wellness Visits (AWV) are not widely received among older adults. In order to increase the uptake of AWVs, a Medicare Advantage (MA) plan in Puerto Rico partnered with a medical group to provide home-based AWVs. The study found that the majority of patients had multiple chronic conditions and were taking multiple medications. Those with nutrition-related conditions, diabetes, or uncontrolled health issues were more likely to be referred for mental health services. While this strategy helped reach high-need patients, coordination of follow-up care is necessary to ensure recommended services are received.