Continuity of Primary Care and the Timing of Preventive Care: Investigating the Relationship Among Medicare Beneficiaries with Fee-for-Service Coverage

Abstract

Timely preventive care is imperative to maintaining good health and receiving prompt treatment when needed. This is especially true for Medicare beneficiaries, who often have multiple comorbidities and complex care needs. We examine whether Medicare beneficiaries with higher continuity of primary care are more likely to adhere to public health guidance for preventive care timing than beneficiaries with lower primary care continuity. We link data from the Medicare Current Beneficiary Survey, which is a nationally representative survey of the Medicare population conducted by the Centers for Medicare & Medicaid Services with Medicare Fee-for-Service carrier and outpatient claims. The purpose of doing so is to examine associations between primary care continuity (a measure of both frequency of visits to each provider and dispersion of care between providers) and timely receipt of two preventive care services (annual flu shot and biennial mammogram screening). We also assess how the strength of that association varies by selected sociodemographic and health characteristics. Results indicate that the proportion of beneficiaries who received an annual flu shot, or biennial mammogram screening did not increase with higher continuity of primary care. However, regardless of the level of care continuity, beneficiaries with regular or high use of primary care (meaning more visits overall) were significantly more likely than beneficiaries with low primary care use to receive preventive services. Rather than focusing on policies that improve continuity of care, facilitating access to and regular utilization of any primary care service among Medicare beneficiaries may be an effective way to increase uptake of preventive services among the Medicare population.