Annual Wellness Visit Hidden Opportunity for Practices, Patients

The majority of the healthcare leaders and policy makers have tried countless incremental fixes - attacking fraud, reducing errors, enforcing practice guidelines, making patients better "consumers," implementing electronic medical records - but none have had much impact. Critics argue that the Affordable Care Act (ACA) is not the solution for a "broken" U.S. healthcare system. Many argue that a system based on competition to provide quality outcomes for the patient (consumer) at the lowest cost is the answer. Some think that a single payer system is the appropriate solution. Whereas others argue that some type of managed care, pay for performance, and health information technology combination can be effective.

Despite these arguments, it is difficult to argue against providing a yearly Annual Wellness Visit (AWV) - a visit that provides evidence-based preventive services and provides a real-time risk assessment. Continuum of care through population health management, care coordination, and Patient-Centered Medical Homes starts with the AWV. This is especially true if the visit is automated and delivered electronically by nonphysician providers, using a cloud-based solution whereby the patient completes the HRA online and the responses trigger automated clinically indicated preventive services, diagnostic tests to identify early chronic disease, a personal prevention plan, and automated capture of ICD-9 HCC Codes.

This yearly face-to-face visit can also be used to capture HCC Codes and outcome data, and data such as baseline clinical status, baseline functional status, patient experience and engagement, long-term clinical status, and long-term functional status.

The data from this visit provides the business and clinical intelligence to document cost-effective quality care and the best possible outcomes. Rapid improvement in any field requires measuring results - a familiar principle in management. Teams improve and excel by tracking progress over time and comparing their performance to that of peers inside and outside their organization. Indeed, rigorous measurement of value (outcomes and costs) is perhaps the single most important step in improving healthcare. Systematic measurement of results in healthcare can improve outcomes.

Despite many advantages, the AWV is the benefit that nobody knows about. A survey from the John A. Hartford Foundation found that 54 percent of respondents had not heard of the AWV and 72 percent had not had an AWV in the last 12 months. The AWV is a positive aspect of the ACA for primary care, increasing RVU productivity and clinical revenue besides all the other aforementioned advantages of the visit. The AWV should not become a lost opportunity. Efforts should be undertaken by all clinical practices to utilize the AWV and make it a priority.