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medicare-wellness

Why the Medicare Annual Wellness Visit should be a High Priority in your Practice

Mark Twain once said that “age is an issue of mind over matter; if you don’t mind, it doesn’t matter.” While this is true in theory, many people face increasing health issues as they get older. However, by receiving preventive healthcare screenings and services, they may be able to lessen the risk of certain illnesses and injuries.

As you probably already know, part of the Affordable Care Act includes the Medicare Annual Wellness Visit (AWV), a program designed to help primary care providers address health risks for seniors and promote those preventive screenings. According to a study published in Health Affairs, though, not even half of primary care practices currently offer these visits, and fewer than 20 percent of eligible Medicare beneficiaries are receiving them, even though it doesn’t cost them anything.

Barriers and Benefits

As with any such program, there are challenges. Many physician practices, especially smaller ones, have fewer resources and an already overloaded staff. Practices that utilize an EHR are more likely to provide AWVs, while those with patients with high medical risk and higher rates of Medicaid enrollment are confronted with lower annual wellness visit rates. In addition, practices located in rural areas experience lower AWV rates than those in larger metropolitan areas.

Overcoming these challenges can be beneficial for physician practices in multiple ways. From improved quality measure performance and improved patient engagement to enhanced tracking of health maintenance services and possible ACO growth, this annual visit can yield more revenue generation along with cost savings. According to the most recent Physician Fee Schedule, Medicare currently pays $161-$227 for initial AWVs and $108-$152 for subsequent AWVs.

The Journal for Primary Care & Community Health noted that physician practices promoting AWVs to their patients could result in gains of early disease detection and improved health outcomes in the population through increased delivery of preventive services. Similarly, the North Carolina Medical Journal found that AWVs supervised by a physician were associated with significantly improved utilization of preventive services and patients who demonstrated significant improvements in adherence rates to preventive services recommendations over six months following their AWV.

Take a look at these other practice benefits outlined by a Health Affairs study:

  • The average annual primary care revenue for practices that adopted the AWV had consistently greater revenue than practices that did not conduct the visit.
  • Practices that conducted the wellness visits had greater patient assignment stability at baseline, with 68.6 percent versus 62.4 percent for non-adopters.
  • Adopters experienced slower decreases in patient assignment stability, with declines of just one percent compared to 4.8 percent among non-adopters.
  • Adopting practices saw a slower increase in average risk, with an increase of 0.02 in risk scores versus 0.04 among non-adopters.

Putting AWVs into Practice

Now that you have a clear understanding of the benefits of AWVs, here are some tips to get the program implemented in your office:

  • Create and implement an awareness campaign to educate your patients about the program.
  • Set goals for your practice to engage in AWVs.
  • Communicate the program and its benefits to practice employees and ensure they understand how to tell patients about it.
  • Analyze practice progress in promoting/achieving more AWVs.
  • Create and utilize an AWV template that includes the necessary health risk assessment (HRA) questions.
  • Ensure team members know how to correctly code for AWVs.
  • Consider the AWV as an add-on to patient follow-up appointments.

A successful AWV effort can result in increased revenue for the practice and improved outcomes for your patients. For additional tips on getting an AWV program started for your practice, visit the CMS website.

For additional support on this topic, contact Erin at erinzielinski@epionhealth.com for a complimentary needs assessment and explanation of services available through Epion Advisory Services.