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Adjusted logistic regression to assess predictors of aACP and the association between aACP and COVID-related mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Medicare fee-for-service beneficiaries 66 and older enrolled on January 1, 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures<\/jats:title>\n                    <jats:p>ACP visits assessed via current procedural terminology billing codes 99497 and 99498: classified as anticipatory if the place of service was ambulatory and outside an annual wellness visit. COVID-19 mortality risks based on age and\/or co-morbidity and practice attribution were assessed pre-lockdown. Hospitalization within 2 weeks of COVID-19 diagnosis and associated mechanical ventilation (MV) were assessed post-lockdown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>In total, 24,935,234 beneficiaries received 470,046,404 encounters in 2020; 1,578,331 were for ACP; of these, 318,813 (20%) were classified as anticipatory. Lockdown abruptly decreased all encounters. The RDD estimate found aACP decreased by 54% (95% CI= \u22120.62, \u22120.46); the relative decline in aACP was smaller for highest COVID-19 mortality risk groups: multimorbidity (\u221242%; 95% CI= \u22120.48, \u22120.35), patients with advanced cancer (\u221244%; 95% CI= \u22120.52, \u22120.36), dementia (\u221235%; 95% CI= \u22120.43, \u22120.27), or ESRD (\u221238%; 95% CI= \u22120.55, \u22120.21). Care from an integrated health system was associated with less aACP. Among 1,314,986 beneficiaries diagnosed with COVID-19, aACP was associated with an increase in adjusted 14-day hospitalization (OR = 1.21; 95% CI=1.17\u20131.26) but a decrease in invasive mechanical ventilation if hospitalized (OR = 0.85; 95% CI=0.77\u20130.96).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Providers followed recommendations to conduct anticipatory COVID-19 ACP with their high-risk patients, which was associated with reduced COVID-19 treatment intensity. This underscores the need for effective identification and dissemination of clinical risk factors in the next pandemic to guide anticipatory decision making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-025-09638-9","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T17:05:25Z","timestamp":1765559125000},"page":"2098-2107","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anticipatory Advance Care Planning Visits and COVID-19 Treatment Intensity Among Medicare Fee-for-Service Beneficiaries: A Retrospective Observational Study"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-6270","authenticated-orcid":false,"given":"Amber E.","family":"Barnato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna L.","family":"Chyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vrushabh P.","family":"Ladage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Meara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"issue":"18","key":"9638_CR1","first-page":"1771","volume":"323","author":"JR Curtis","year":"2020","unstructured":"Curtis JR, Kross EK, Stapleton RD. 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