Seven Reasons Why the Medicare AWV is Good for Physicians and Patients

June 13, 2013
Averel B. Snyder, MD

Physicians need to realize the benefits of Medicare Annual Wellness Visits and put a plan for the service in place to benefit their patients and their practice.

Two years after the announcement of the Medicare Annual Wellness Visit (AWV), the service is still dramatically underutilized. Recent reports vary on estimates that between 11 percent and 17 percent of beneficiaries have had the free service. There are still many physicians and patients that know very little about it.

What is good about the Medicare AWV?

1. The visit enables the practitioner to identify evidence-based preventive services that the patient has not had in the past (only 40 percent of men and 30 percent of women have had all their preventive services). This will lead to decreased utilization of healthcare services and decreased costs.

2. The patient receives advice and counseling to improve unhealthy lifestyle behaviors and improve health and quality of life.

3. The provider receives more reimbursement and RVUs than any other primary-care service.

4. The provider identifies high-risk patients in real time and can act appropriately utilizing care coordination tools and population health management.

5. Delivering the AWV and providing the services satisfies 25 HEDIS quality measures.

6. The visit captures business and clinical intelligence for the individual practice or the managed care organization.

7. Capture of the appropriate ICD-9/HCC data can be leveraged to Medicare Advantage Plans and third-party providers of chart audits and risk assessments to increase incentive payments to the providers

Some say the downside to delivering the AWV is that it is time consuming and interferes with work flow of the practice.

Not necessarily so. There are automated software solutions to assist in the delivery of the AWV. Such tools have been featured on the AHRQ Innovations website. Given the tool, the individual practice can utilize the most appropriate work flow for that practice.

Examples of avoiding work flow obstacles at your practice include:

1. Patients are scheduled for AWV when signing out of problem-oriented visit.

2. Schedule cards given to the patient with instructions to complete health risk assessment (HRA) online.

3. HRA completed at time of visit with the assistance of a medical assistant.

4. Patient sent home with hard copy HRA and stamped envelope to the practice. HRA completed, mailed, and input to system prior to visit.

5. Patients complete HRA with assistance via telephone.

6. Kiosk or tablet entry of data at time of visit.

The bottom line is that the AWV is a win-win for all involved. Patients are better educated and more engaged. The quality of healthcare is improved; healthcare costs are decreased; and revenue is increased for providers and managed care organizations. Physicians need to take the time to plan their practice's Annual Wellness Program.