The annual wellness visit (AWV), funded by Medicare, is an opportunity to communicate to your senior patient population and understand their needs at a deeper level, providing them a free opportunity to assess and advocate for their own health going forward.
I work in an internal medicine practice where over half of our patients have Medicare as their primary insurance. As a certified physician assistant (PA-C), I see several patients every week for this type of visit.
The AWV is not intended to be a typical appointment aimed at treating acute illness or chronic conditions. Rather, it is more of a discussion than an exam, focused on assessing the patient's current health baseline and helping them understand how health maintenance and prevention will keep them out of the doctor's office.
Building on this discussion, I can then coordinate care with specialists and provide continuity of care going forward. This visit solidifies these patients in your practice as they begin to understand it is their "medical home." This is a visit that all seniors should have, even those who feel good and are not in need of healthcare at the moment — but may need your encouragement to understand its availability and importance.
To make the most out of this visit, here are four questions to ask your patients when scheduling the AWV appointment:
1. Can you create a health history folder and bring it to your appointment?
The appointment will go more quickly and be less stressful if the patient has already made a list of vaccinations, prior surgeries, and treatment dates. Your records probably don't include that flu or shingles vaccine the patient got at the local pharmacy.
2. Can you bring a list of all specialists you have seen in the past few years?
Many patients self-refer and may be seeing a cardiologist, an OB/GYN, urologist, etc. This list may bring to light medical issues that the patient hasn't mentioned.
3. Can you bring in all prescriptions, supplements, and over-the-counter medications in their original containers?
This ensures you have the correct information on dosage and frequency and allows you to discuss any concerns about drug interactions or duplication.
4. Do you have an advanced directive?
The AWV is a unique opportunity to discuss end-of-life issues. If patients have one, scan it into their chart for use should the need arise. If they don't have an advanced directive, you can give them one to fill out or take home to discuss with family. You are doing them a great service by provoking this discussion.
The AWV can be a vehicle to ensure early detection. It allows you to screen for early identification tests based on risk factors. However, it is important in this population especially to prioritize scheduling so the patient is not overwhelmed with a battery of follow-up tests.
The AWV collects a significant amount of baseline data, so the first appointment can take an hour. As the name implies, it is an annual visit, and in subsequent years the appointment should be shorter.
Some physicians feel the reimbursement is too low for this comprehensive visit. However, if your practice markets the annual wellness visit effectively, it can provide additional revenue from new patients and cement your relationship with existing ones.
Certified PAs are highly qualified to manage the annual wellness program in your office. We are highly educated, nationally certified, and licensed by state medical boards. Studies show we provide high value as we deliver cost-effective, quality care.
Consider making the AWV a "best practice" for your office, and reach out to your senior population to position it as a Medicare-paid opportunity to improve their health.
Valery DeSimone has been a PA for 12 years, with the last four years focused on internal medicine. She is employed by Premier Physicians Medical Group in South Orange County. DeSimone is certified by the National Commission on Certification of Physician Assistants (NCCPA).