1984-P: Primary Care and Endocrinology Visits among Medicare Beneficiaries with Diabetes, 2017–2021

Introduction and Objective: Optimal diabetes management benefits from a team-based approach with primary and specialty care. Contemporary patterns of primary and endocrinology care utilization by people with diabetes are unknown. In this study, we quantify use of primary care and endocrinology services by older adults with type 1 diabetes (T1D) and type 2 diabetes (T2D) in the U.S. Methods: We conducted retrospective analyses of 2017-21Medicare fee-for-service claims linked to National Plan and Provider Enumeration System data, including U.S. beneficiaries(linked to state using FIPS) ≥65 years old with T1D or T2D, continuously enrolled ≥12 months. For all patients, we identified primary care (general, internal, family, geriatric) and endocrinology encounters during 2018-2021. Results: Among 1,610,584 adults, 0.6% (n=9,545) had T1D and 99.4% (n=1,601,039) had T2D. Among adults with T1D, 71.3% had ≥1 endocrinology visit, compared with 16.7% of those with T2D with wide state variation, ranging between 37.4-89.2% for T1D and 7.8-29.6% for T2D (Figure). Overall, 79.6% of adults with T1D and 77.3% with T2D had ≥1primary care visit, ranging between 64.1-91.8% in T1D and 58.6-87.9% in T2D. Conclusion: These findings highlight substantial geographic disparities in access to specialty and primary diabetes care, underscoring the need for policies addressing endocrinology and primary care availability and access. Disclosure K.S. Robinson-Ector: None. K. Miller: None. A. Bazemore: None. R. McCoy: None. Funding Kaitlynn Robinson-Ector is supported by a National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) institutional training grant (5T32DK098107-09)