Use of preventive wellness office visits among Medicaid members with disabilities: Analysis of Medicaid billing data

Background:  Seven out of ten deaths in America are attributable to chronic diseases and almost one in every two adults has at least one chronic illness.  Because the majority of these conditions are preventable, the use of preventive health services has been recommended.  For people with disabilities, preventive health services are particularly important to avoid additional health conditions and maintain their health and independence.  Despite its importance, however, there is little information about their use of preventive health services.  This study explored the use of preventive wellness office visits by persons with developmental and physical disabilities.  

Method: FY2011 claims data of Aged, Blind, and Disabled (ABD) Medicaid members (n = 39,653) residing in a large Midwestern state were used. Utilizing Clinical Classification Software (CCS), a classification of ICD9 codes, members with developmental disabilities (e.g., communication disorders, developmental disorders, intellectual disabilities, and learning disorders) and physical disabilities (e.g., spinal cord injury, multiple sclerosis, muscular dystrophy, polio, cerebral palsy, and spina bifida) were identified.  A preventive office visit was defined using Current Procedure Terminology (CPT) codes associated with the claim. 

Results: Among 2,640 members with developmental disabilities, 12.2% (95%CI: 11.0%-13.5%) have claims associated with wellness office visits.  The rate was 6.9% (6.2%-7.6%) for 4,681 members with physical disabilities. For both groups, females were significantly more likely to access the service than males.  

Conclusion:  Utilization of preventive health care by ABD Medicaid members, particularly those with physical disabilities and males, needs be encouraged to prevent or delay the onset of additional chronic conditions.